TOPIC: Viral Load - Quantitative vs Qualitative

Hep C Viral Load can be quantitative (undetectable, <15, or 15-100,000,000) or qualitative (undetected/detected).

In Australia Medicare will pay for 2 quantitative and 4 qualitative tests a year. Note that Medicare will only fund Hep C viral load testing when it is a) ordered by a specialist or b) ordered by a GP for a patient having treatment so please make sure you add "Having DAA treatment for HCV" in the clinical notes or you patient will get either a bill or the test won't get done. Also note that for quantitative testing you need a specialist to authorise it (they don't have to order it) but you need to add something like "Having DAA treatment for HCV. Authorised by Dr John W Freeman FRACP". Apparently GPs can't be trusted by the HIC to order this test alone....

So unless you are willing to pay you can have:

• Start: Quantitative - some number like 1,000,000 (log 6)
• 4 weeks: Quantitative - some number like Undetected (0), < 15 or 15-200 (usually)
• 12 weeks: Qualitative - Undetected (UND) - yet to see Detected
• SVR4: Qualitative - Undetected here is a 96% chance of absolute cure
• SVR12: Qualitative - Undetected here is a 99% chance of absolute cure
• SVR24: Qualitative - Undetected here is a >99% chance of absolute cure and the gold standard

Thanks for this - I had no idea

Do you know the cost of a quantitative test in NSW?

The list price is $180-200 AUD but if you ask nicely I know Sonic (blue disc with red double helix) labs - the have many different brands - have been doing them for around $135. Ask for a quote is my tip!

Yeah I got quoted $200 from Douglas Hanley in Sydney

Tell them they are dreaming! Ring Laverty and say you've been quoted $140 and ask if they can do better.

In case of emergency ping me and I will ask for you.

Thanks for this very useful presentation.
Before treatment VL 9 million. I can not wait and want to do 2 weeks VL. To see how the treatment goes.
I hope the result will be encouraging!
Fingers crossed.

I just got a quote from S&N Pathology Brisbane for $92.20 & QML Pathology Brisbane for $158.38 for a HCV, PCR, RNA VIRAL LOAD (QUANTITATIVE ) Blood Test.
So you can see the price difference just between these 2 Pathology Labs.

Went to see the GI specialist at the Gold Coast University Hospital today. Results from EOT blood tests show I am still UND. I know that was to be expected, but still felt a teeny bit of anxiety beforehand.

I was offered a Fibroscan, accepted of course, and it showed a reduction from 6.2 to 4 (kPa). I hadn't expected this to happen so quickly, a big bonus and feeling very happy.

ALT = 16 and AST = 23 (34 and 41 a year ago).

They are monitoring several others on generics and said that SVR24 'has gone out with interferon' and is no longer necessary on DAAs. SVR12 is now considered sufficient.

So I have a pathology request for end of March and then it's all over red rover.

Edit: dear mods, I'm not sure if this post should be here, feel free to move it...

That's such great news Joy and what a bonus to get the Fibroscan results as well. Interesting about the SVR24 comments and it indicates their confidence in the DAAs.

Great news Joy

I think if I had cirrhosis and/or had relapsed from interferon I would probably still want to be tested at 24 weeks after EOT. There's a psychological hangover from interferon that will take time to clear. But yes Coral, it's reassuring that specialists are confident about DAAs, and are preparing for the PBS rollout. I expect the EOT Viral Load test will also be eliminated if UND is achieved earlier.

The staff at the GCUH today were wonderful. I haven't had to pay for any tests or doctors visits, and am very grateful for that. Hearing how difficult and expensive it is for people in other parts of the world makes me appreciate Australia even more. Might stick around.

"I think if I had cirrhosis and/or had relapsed from interferon I would probably still want to be tested at 24 weeks after EOT. There's a psychological hangover from interferon that will take time to clear."

You are right about that Joy. I would be one of those of the old school of interferon. No way could I walk away from an UND test at 12 weeks and be confident that it was over. Probably irrational given the stats on SVR12, but that's how it is.

dt

Hi
Could some one please help me read the results that are in the attached file. Understand 'not detected' but not the quantification analytical range.

If you have a look here you will see what it actually looks like:

fixhepc.com/forum/viral-load-and-svr/563...al-load-testing.html

So the 35 refers to <35 being the lower limit of quantification. Below this we can often still see a "smudge" and that is <35 detected. You have a full "Not detected" although there was a technical problem with the test so they are saying "if it had worked properly we might have detected it".

Simple solution: Just do a qualitative detected undetected repeat.

Thank you so much Doc James
My specialist wouldnt discuss it with me and I don't know why. I will ask for a repeat test.