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TOPIC: QUANTITATIVE PCRs with LLOQ missing - UK

QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12178

  • mgalbrai
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hey jaz,
yeah, the deal is, at least in the US, is they see if you have the virus present-period. not antibodies, but the HCV RNA itself-qualitative.
if thats undetected or negative, thats it.
if its positve-detected-then a quantitative is done. this seems to be the "failure to communicate" area, as i have referred to earlier. if they can't find enough virus to measure, its usually shown as below their testing capability threshold, like <15 or <12. my PCP's nurse kept telling me it was "unmeasurable" by email. when I saw the actual test, she was right. there wasn't enough virus to measure. the 8 week test was negative. undetected. she still told me the same thing when she informed me by email: "good news, your virus is unmeasurable".
trying times.....
m
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G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12186

  • Ariel
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Gaj wrote:
Hi Ariel,

I was aware that after seeking medical advice you had retested with a LLOQ 15 test, my fault for sloppy use of grammatical tense :blush:. I have edited my post to correct that.

You are right about a good doctor being able to explain all this information. Finding one that you trust and making sure you understand their advice (in whichever country you live) should be a far more important area of focus than looking for various tests and test labs by ourselves. :+1: #flower

Totally
Its a doctor job
And find a good one who defers to those few who have experience in DAA therapy yup
No brainer. Cheers Gaj :+1:
Mike ty for explaining the US protocol
Still makes sense to me neg and UND sounds good to go x
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12217

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mgalbrai wrote:
It seems with my lab, its:
1. Qualitative-Is HCV RNA present? If its not-end of test. "Negative"
If "Positive", go to step 2:
2. Quantitative- If the v/l is below the concentration level needed to measure, in my case, <15, then thats it. the notice from my PCP's nurse said my first test result was "unmeasurable" in her email. That was the same as "undetected" to her, but not to me. Unmeasureable is a great result, but the word I was waiting to see was "Negative".
It is also the way are working the two labs where my VL was tested.
Thanks M for explaining so well!

Yes, unfortunatelly I know the concern with LLOQ. Yes, a good doctor that explains what's going on is priceless!

My first lab has LLOQ 15.
But on week 8 when the result came <15, my GI advised me to retest on another lab, also with LLOQ 15!
Phew! week 8.5. UND! :ohmy: :silly: :)

Same lab when EOT. UND! :ohmy: :silly: :)

Feeling great and grateful for these two UND!
#duck #love #flower

HCV since I don't know. Diagnosed in 2010.
GT1b, F0/F1, VL 9M, ALT 44, AST 42, Tx naive,
started 12 wks Twinvir on 06.12.2015. Feeling great and grateful :)
virus not detected 06.02.2016 & SVR24
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Last Edit: 3 years 8 months ago by isaing4.
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12219

  • darbara
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SAME THING HERE NURSE AND DOC TOLD ME <25 UNMEASURABLE so.................................
Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12221

  • kenbasman
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I still am fuzzy about the difference between unmeasurable and unquantifiable and how the quantification numbers relate to UND, but then again I am fuzzy about a lot of things!
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12244

  • Gaj
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Hi Ken,

You aren't the only one and I suspect a lot of it is semantics and/or poor choice of wording by Labs.

The quantitisation test basically has three levels:

1. "We can't see any virus at all". This is Undetected or Negative and is thought to be anything around 5 iu/ml or less for most of the modern tests.

2. "We can see some virus, but there is too little for our test to measure accurately". This is Detected and is when you get a result back that is <12 or <15 or even the older <30. It is below the range that the test can measure accurately but still high enough to be detected.

3. "We can see the virus and there is enough for it to be in the range that we can measure accurately". Again it is Detected but the result will be a whole number, maybe 19 iu/ml or 504 iu/ml or something. So it is within the accurate range of the test and they can tell you an actual figure with confidence.

The problem is in the way these results are then interpreted and reported by each lab as there appears to be no standard for this and they each do their own thing. Undetected or Negative are quite clear in that the virus can't be seen. But if it is reported as Unmeasurable does that mean that they can see it but can't measure it accurately or they can't find any to measure in the first place? And most of the time the people that you and I can get to speak to in the lab have no better idea than us and far less invested in getting the right answer or the skills to explain it clearly to us.**

This is why you need to try to find a good doctor who can negotiate the correct answer from the right people at the lab and then explain to you in terms you can understand.


**(Don't get me started on the lack of customer service provided by most businesses these days or their need to give us a "unique user experience" instead of a bloody standard that we can all understand!)
#rant
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 3 years 8 months ago by Gaj.
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12256

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Great answer. Love ya Gaj!
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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QUANTITATIVE PCRs with LLOQ missing - UK 3 years 8 months ago #12329

  • mgalbrai
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I still like the "Shit's Gone" stamp.
Something so......definite about it.
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forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
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