Home Forums Main Forum Patient Stories Threads best left unread, containing things better left unsaid QUANTITATIVE PCRs with LLOQ missing – UK

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  • #13134
    Avatar photomgalbrai
    • Guardian Angel
    • ★★★★★
    @mgalbrai

    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


    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

    #13142
    Avatar photoAriel
    • Guardian Angel
    • ★★★★★
    @ariel
    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

    #13175
    Avatar photoisaing4
    • Guardian Angel
    • ★★★★★
    @isaing4
    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: <img style=illy:' /> :)

    Same lab when EOT. UND! :ohmy: <img style=illy:' /> :)

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

    woohoo-dancing-banana.gif


    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
    isaing4@gmail.com

    #13177
    Avatar photodarbara
    • Guardian Angel
    • ★★★★★
    @darbara

    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

    #13182
    Avatar photokenbasman
    • Guardian Angel
    • ★★★★★
    @kenbasman

    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

    #13209
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    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:

    #13223
    Avatar photokenbasman
    • Guardian Angel
    • ★★★★★
    @kenbasman

    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

    #13299
    Avatar photomgalbrai
    • Guardian Angel
    • ★★★★★
    @mgalbrai

    I still like the “Shit’s Gone” stamp.
    Something so……definite about it.


    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

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