What exactly does it mean to be undetected?

[atomic dog]

I've read on this forum that HCV/RNA can only be detected to a certain low level, but not zero. So at what level (IU/mL) are you considered to be undetected?

[DisabledHepcat]

Undetected is a good sign when off the meds for 12 weeks
Undetected during treatment is usual.
The IU/ML  of undetected depends on which test is done but they are all pretty much very low readings.

The major test you are concerned with is after the treatment get tested in 12 weeks.
If undetected you are considered cured but you can still get re-infected by sharing blood with another infected person. Harvoni doesn't make you immune to HCV, it murders it.

[Mike2]

Hey,
It's my understanding  Harvoni stops the ability for the virus to replicate. Even after being undetected  we will always have the antibody for Hep C. That being said if undetected after 12wks post treatment would mean that you are cured and the virus can no longer replicate itself. I'm waiting for my 31/2wk. results on Harvoni. I just found out last night my liver panel was normal first time in 40yrs!! Next week I will get my viral load. My prayers are with all of us to rid ourselves of this dilapidating disease. Good Luck.

[charly8]

Undetected means the test can not detect any virus in the sample of blood drawn.  Some tests are more sensitive then others.

Undetected does not mean that there is no virus in the sample, it could be there just in such small numbers that the test is not sensitive enough to detect them.

Undetected does not mean that there is no virus in the liver, where the virus can replicate.  The amount of virus in the liver is much larger than in the blood circulation.

From my readings, when on treatment the virus in the blood can be more easily removed, but the virus in the liver is much harder to remove because in the liver is where it can replicate and is in much larger numbers. 

[atomic dog]

Appreciate the responses. I notice Charly8 that undetected in your case is <15. My understanding is that no test can detect the virus at lower levels, i.e. zero. So a sustained virology response at 12 weeks or 24 weeks, depending on the duration of the treatment (SVR or <15, for instance), indicates that the virus is gone.

[dragonslayer]

>> So a sustained virology response at 12 weeks or 24 weeks, depending on the duration of the treatment (SVR or <15, for instance), indicates that the virus is gone.
<<

Atomic,

Not quite... Assuming a test has an LLOQ of 15, there is a difference between 'UND' and  'Detected < 15'.  Its the former that, at 12 wks post treatment, generally equates to  SVR12.

[charly8]

Appreciate the responses. I notice Charly8 that undetected in your case is <15. My understanding is that no test can detect the virus at lower levels, i.e. zero. So a sustained virology response at 12 weeks or 24 weeks, depending on the duration of the treatment (SVR or <15, for instance), indicates that the virus is gone.

SVR means the virus has not replicated back and therefore has been eradicated from the body.  Its important to note that SVR is measured at 12 weeks AFTER the end of treatment. ie 12 weeks without medication.  This gives ample time for the virus (if present) to replicate enough to be detected again by the PCR test.  The thought is that after 12 weeks if the virus is not detected than it has been removed completely from the body.

[atomic dog]

Cool. Got it. BTW, what's LLOQ?

[atomic dog]

Charly8, If you don't mind me asking, what did your doc add RYB if you were undetected after 2 weeks?

[charly8]

Charly8, If you don't mind me asking, what did your doc add RYB if you were undetected after 2 weeks?

To give the best chance of SVR.  My fibrasure was showing F3 and I have been treated 2 other times.  If I was an F4 I would be going for 24 weeks.  I wanted to try to see if I could get approval for 24 weeks but my doc did not think the insurance would cover it.  So the next best thing was adding RYB.  Looking at the studies, there was not much correlation between people that went undetected at 2 weeks vs 4 weeks and their relapse rates.  Just as many people relapsed that went undetected at 2 weeks as did at 4 weeks.

 I wanted to try to extend to 24 weeks because it looks like a sure thing for SVR.  Doc said that the insurance would not cover it, so he gave me the option of adding RYB.  Harvoni has been a breeze compared to the previous treatments and 8 weeks of adding RYB is "manageable" considering I did it for 72 weeks previous.

[Tpropane]

The viral load can range from "not detected" to hundreds of millions. The meaning of "not detected" or "negative" differs, depending on the test used. In one lab, the detection limit for the *quantitative* HCV RNA test by *PCR* is 200 virus equivalents/ml (and with the *qualitative* test they can detect down to 10 virus equivalents/ml). The less expensive quantitative *bDNA* test has a detection limit of about 200,000 virus equivalents/ml. So it is less sensitive, but above its detection limit it is more accurate than the PCR test.
2 different tests. 1 much more sensitive than the other. That is how I knew I failed treatment on Triple therapy. I had an undetected on a quantitive test but doc ordered the qualitative test and I was still detected.
I went from less than 10 to about a million from EOT in 2011 till just before starting Harvoni.
Ask your doctor which test he/she is ordering.
Best to all!
Tpropane.

[dragonslayer]

Cool. Got it. BTW, what's LLOQ?

LLOQ = "Lower Limit Of Quantification"
LLOD = "Lower Limit Of Detection"

[atomic dog]

I've had C for almost half a century and never heard those, thx,