labs and their techniques?

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18 March 2016 at 8:15 pm #14131
kenbasman
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- Guardian Angel
@kenbasman
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

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
18 March 2016 at 8:31 pm #14132
LondonGirl
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- Guardian Angel
@londongirl
Hi ken,

Dr Freeman gave me this info :

Abbot and Roche make the PCR test.

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

The tests I order are either

HCV RNA PCR quantitative
HCV RNA PCR qualitative

GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 ‘In the slow lane’
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
18 March 2016 at 11:05 pm #14133
darbara
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- Guardian Angel
@darbara
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

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
19 March 2016 at 2:54 am #14148
Greedfighter
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@greedfighter
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!
19 March 2016 at 4:35 am #14156
kenbasman
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- Guardian Angel
@kenbasman
Thanks everybody. I thnk i begin to know whqt to look for,
Ken

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
19 March 2016 at 8:28 am #14164
darbara
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- Guardian Angel
@darbara
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

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
19 March 2016 at 9:20 am #14165
Dr James
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@fixhepc
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.

YMMV
9 October 2016 at 3:22 am #23645
countless
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- Recovery Champion
@countless
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.

Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot – undetected
9 October 2016 at 1:25 pm #23664
Dr James
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@fixhepc
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.

YMMV
9 October 2016 at 4:49 pm #23672
countless
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- Recovery Champion
@countless
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

Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot – undetected
9 October 2016 at 9:29 pm #23685
Sven
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- Guardian Angel
@sven
Countless you are in the right place at the right time. Keep us posted!
Your almost there, Congrats!

Contracted HCV 1980’s
Geno Type 1a
F3 ( doc says once treated I’ll be F2 maybe F1)
Meds shipped 6/17/2016 arrived early 7/2016

Viral count – 3,471,080

4 week quantitative bloods: August 17, 2016. I have been diagnosed as <15 (told undetected)

8 week quantitative bloods: September 14th. I have been diagnosed as <15 (told undetected)

11 week PCR RNA Qualitative bloods: September 26th 2016 – Undetected

December 19th 2016: Cured!
Viral count: zero!!!
2018 viral count: still zero!
Cured!
19 October 2016 at 11:54 am #23951
countless
- Topics: 6
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- Total: 45
- Recovery Champion
@countless
I did not exactly realise that 2 years ago neither these medications nor this site existed , what you saying makes sense now..

Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot – undetected
19 October 2016 at 2:04 pm #23952
mgalbrai
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- Guardian Angel
@mgalbrai
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

Curehcvnow@gmail.com
http://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
30 October 2016 at 5:41 am #24060
countless
- Topics: 6
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- Total: 45
- Recovery Champion
@countless
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 ?

Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot – undetected
30 October 2016 at 6:56 am #24064
Gaj
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- Guardian Angel
@gaj
.
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

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
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