TOPIC:

Hi there,
I am in the middle of Mexico here and I am trying to learn what kind of lab techniques I should be looking for to get my VL results from here on out. I finished treatment almost 2 weeks ago. A lab guy here (they send out the blood so he doesn't know much about it) thought there were different techniques/machines used to get the results and that possibly some are more accurate than others. I would like to be able to call around to different labs in the country and make sure they are using the best methods possible to read my VL or lack thereof. Anybody have a clue what that might be?
thanks,
Ken

Hi ken,

Dr Freeman gave me this info :

Abbot and Roche make the PCR test.

The usual one here is the Roche TaqMan COBAS molecular.roche.com/assays/Pages/COBASTaqManHCVTestv20HPS.aspx

The tests I order are either

HCV RNA PCR quantitative
HCV RNA PCR qualitative

Where I live its state provided and they use the TaqMan COBAS which <25 as LLOQ
The link is provided above by LG
Features
CE-IVD: Sensitivity (LOD; genotype 1) – plasma: 9.3 HCV RNA IU/mL, serum: 8.8 HCV RNA IU/mL; linear range – 25 to 3.91×10^8 IU/mL
FDA-IVD: Sensitivity (LoD; across all genotypes) – 20 IU/mL; Linear range –Quantitation of HCV RNA from 25 to 3×10^8 IU/mL
COBAS® TaqMan® 48 Analyzer for automated real-time PCR amplification and detection

The lab I use, Quest Diagnostics, only has RNA & PCR RNA Quantitative.

These were my results.

HCV RNA IU/mL <15 Not Detected

HCV RNA,QN,PCR <1.18 Not Detected

Edit: Apparently the first test, RNA IU/mL is the Qualitative result and shows no active infection. The second test is quantitative and confirms it!

Thanks everybody. I thnk i begin to know whqt to look for,
Ken

As in my case <25 and a note UNDETECTED at the LLOQ.
Abbot test is <15 LLOQ
Roche Cobas Taqman <25 LLOQ
AND if its detected it will mention as detected but sometimes the guy who writes the report forgets to write UNDETECTED <15, <25 <...... SO DONT PANIC

Unless you are one of the rare few who had normal/near normal LFTs pre treatment in all the relapses I have seen I've known it's coming a week in advance because the LFTs are off again.

A few patients scared me with elevated enzymes but came back undetected - this traced back to celebrating with alcohol.

Any of the viral load tests will pick up a relapse.

Dear Dr.Freeman
As you mentioned that very few have normal or near normal liver function tests and as I am one of those I wondered whether you have observed any particular traits of disease which presents with LFTs being normal. My ALT is 45 , viral load about 400 000 , no symptoms but fibroscan is 12. Is there anything that could be read into this unusual combination or it is of no relevance? Thank you.
If anybody else has a clue the replies are welcome.

Hep C can be remarkably unsymptomatic until it isn't. Many people can wait for treatment. @12kPa you are almost cirrhotic. For you waiting may be a mistake.

O yes I can not wait to start trratement , I hope medicines would be shipped tomorrow and my immense gratitude to you for giving me this opportunity. Just been pondering trying to make sense of me and my hepatitis

Countless you are in the right place at the right time. Keep us posted!
Your almost there, Congrats!

I did not exactly realise that 2 years ago neither these medications nor this site existed , what you saying makes sense now..

Yes Countless,
Welcome to the tip of the spear in the battle to wipe out HCV.
As Sven says, the time is right.
Good luck,
m

Thank you.
On the topic of lab results - does anybody know how to convert viral load counts in units into ones in fmols and viceversa ?

.
I haven't seen VL expressed as fmols, do you mean Log¹⁰ scale?
In which case it is a logarithmic progression which I don't have the skills to explain how to calculate but can supply the below approximations. (Sorry about the wonky columns, too much work to tabulate on an iPad )

Log¹⁰    iu/mL
7.0   10,000,000
6.9    7,943,282
6.8    6,309,573
6.7    5,011,872
6.6    3,981,072
6.5    3,162,278
6.4    2,511,886
6.3    1,995,262
6.2    1,584,893
6.1    1,258,925
6.0 1,000,000
5.9    794,328
5.8    630,957
5.7    501,187
5.6    398,107
5.5    316,228
5.4    251,189
5.3    199,526
5.2    158,489
5.1    125,893
5.0    100,000
4.9    79,433
4.8    63,096
4.7    50,119
4.6    39,811
4.5    31,623
4.4    25,119
4.3    19,953
4.2    15,849
4.1    12,589
4.0  10,000
3.9    7,943
3.8    6,310
3.7    5,012
3.6    3,981
3.5    3,162
3.4    2,512
3.3    1,995
3.2    1,585
3.1    1,259
3.0.   1,000
2.9    794
2.8    631
2.7    501
2.6    398
2.5    316
2.4    251
2.3    200
2.2    158
2.1    126
2.0 100
1.9    79
1.8    63
1.7    50
1.6    40
1.5    32
1.4    25
1.3    20
1.2    16
1.1    13
1.0  10
0.9    8
0.8    6
0.7    5
0.6    4
0.5    3
0.4    3
0.3    2
0.2    2
0.1    1