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Author Topic: UND?? I may have misspoke?  (Read 10952 times)

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Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
UND?? I may have misspoke?
« on: August 15, 2015, 08:27:46 am »
Well my nurse told me I was undetected... but after careful reading and research , I see that my printed results say
"hepatitis C Quantitation <15   IU/mL   HCR RNA detected.

Technically this is not UND... correct??

and a question - is the qualitative test the one that can tell you if you are UND??  and is this test administered at end of TX?

any help understanding this would be greatly appreciated.

thanks,
dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline Trish1

  • Member
  • Posts: 19
Re: UND?? I may have misspoke?
« Reply #1 on: August 15, 2015, 09:22:38 am »
Hi DM ,  you are correct, technically you are detected but your number is less than 15.  When I received my 4 week results I was doing the happy undetected dance only to find out I was still detected. The other test you asked about is a more sensitive test only it does not count the virus it just says detected or undetected.   I asked my doctor to extend my 8 week TX to 12 and he said no, that my number at less than 15 was fantastic and I did not need 4 more weeks.  I have 2 pills left then I am done.    I go for my 8 week labs on Tuesday and hope it comes back undetected this time.   Even if it is still detected I am told that SVR is still very probable. Just wanted to let you know you are not alone. 
Age 51
Infected 1983
GT 1a
VL 5.1m 
Bx 2004 - Grd 1 Stg 1 
Tx naive
Metavir Score 5/26/15 - F0-F1
Started Harvoni 6/23/2015 (8 wks)
4wk (during tx) - detected <15
8 wk EOT - undetected
4 wk after tx - undetected - SVR4
12 wk after tx - undetected - SVR12

Offline drummerman

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  • Posts: 538
  • For those regarded as warriors....
Re: UND?? I may have misspoke?
« Reply #2 on: August 15, 2015, 09:26:31 am »
thanks Trish,

sounds like you are right on track!

When you go back for your final lab will they do the more sensitive (qualitative) test?

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline Trish1

  • Member
  • Posts: 19
Re: UND?? I may have misspoke?
« Reply #3 on: August 15, 2015, 09:29:03 am »
My guess is yes.  They did both tests at my 4 week mark.
Age 51
Infected 1983
GT 1a
VL 5.1m 
Bx 2004 - Grd 1 Stg 1 
Tx naive
Metavir Score 5/26/15 - F0-F1
Started Harvoni 6/23/2015 (8 wks)
4wk (during tx) - detected <15
8 wk EOT - undetected
4 wk after tx - undetected - SVR4
12 wk after tx - undetected - SVR12

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: UND?? I may have misspoke?
« Reply #4 on: August 15, 2015, 09:35:20 am »
Both at 4 weeks!!!??  Wow, !  did you ask for both?  Did your insurance cover both?

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline slats1056

  • Member
  • Posts: 765
  • SVR to all and to all a good life!
Re: UND?? I may have misspoke?
« Reply #5 on: August 15, 2015, 09:50:51 am »
Ditto drummerman, do You have to ask for them or is it automatic? Is up to the Dr., the Lab, or Ins. co.? Good news either way. Can't wait for My labs Monday. Feel very optimistic after reading all of Your posts & results.
73 non ab 98 hep c refused pegint/riba
6-15 Gen.1b 1/2 MIL ALT72 AST37 No cirrhosis
7-15  Harvoni 12 weeks
10-14-15 EOT VIRAL LOAD NON-DET  
12-30-15 EOT+12 VIRAL LOAD NON DET  SVR12            8-9-18 HCV LOAD 1.02IU/ml AST22  ALT30 RELAPSE?
9-18-18 confirmed gt 1b relapse
10-16-18 approved 16 weeks Mavyret

Offline Trish1

  • Member
  • Posts: 19
Re: UND?? I may have misspoke?
« Reply #6 on: August 15, 2015, 10:20:16 am »
I did not ask for both, my doctor just ordered them.  Yes, my insurance paid 100 %
Age 51
Infected 1983
GT 1a
VL 5.1m 
Bx 2004 - Grd 1 Stg 1 
Tx naive
Metavir Score 5/26/15 - F0-F1
Started Harvoni 6/23/2015 (8 wks)
4wk (during tx) - detected <15
8 wk EOT - undetected
4 wk after tx - undetected - SVR4
12 wk after tx - undetected - SVR12

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: UND?? I may have misspoke?
« Reply #7 on: August 15, 2015, 11:52:28 am »
Wow!   guess its just what the doc orders.  Never heard of one  ordering a quantitative and qualitative at the same time.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline dragonslayer

  • Member
  • Posts: 873
Re: UND?? I may have misspoke?
« Reply #8 on: August 15, 2015, 02:48:14 pm »
In the Gilead Harvoni  trials, their criteria for SVR was viral loads measuring < the quantitative test's LLOQ which in their case was 25.  Point is, many folks who test low level detected at EOT go on to SVR; that is one of the reasons on-treatment testing is not part of the Harvoni treatment protocol... There is little correlation between  on-treatment testing results and eventual SVR. 
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: UND?? I may have misspoke?
« Reply #9 on: August 15, 2015, 04:16:31 pm »
Thanks DragonSlayer,

Well the test I was give would measure down to 15, so I guess if that continues I would be considered SVR?

Wondering why they don't do a qualitative test for all at EOT.  Too expensive or just plain unnecessary when you are looking at such low numbers.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline dragonslayer

  • Member
  • Posts: 873
Re: UND?? I may have misspoke?
« Reply #10 on: August 15, 2015, 09:26:00 pm »
Thanks DragonSlayer,

Well the test I was give would measure down to 15, so I guess if that continues I would be considered SVR?

Wondering why they don't do a qualitative test for all at EOT.  Too expensive or just plain unnecessary when you are looking at such low numbers.

dm

I may be wrong here, but the Qualitative test may cost more.  But I think more to the point is EOT results dont jibe well with SVR.  I and several others were detected at EOT, but went on to clear at 12 wks post and later.  So since the test is not that probative, why do it?  There's far too much waste driving up costs anyway to waste time doing tests which arent probative.  Also, since qualitative tests dont report a viral load, its importance is muted somewhat.  The Abbott Realtime Assay has an LLOQ/LLOD of just 12 which is pretty damn sensitive.. Plus, it reports a Viral Load, which is really important to check for SVR... Its not just whether or not the virus is present which counts, but how much or how little.   If at 8 wks post treatment, for instance, you are detected but less than LLOQ, thats a pretty damn good sign of SVR, yet the Qualitative test would just report 'Detected', sending the wrong signal to both Dr. and Patient.. See my point?
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline slats1056

  • Member
  • Posts: 765
  • SVR to all and to all a good life!
Re: UND?? I may have misspoke?
« Reply #11 on: August 15, 2015, 09:54:12 pm »
 Dragonslayer That makes perfect sense. Adding that would probably confuse people more than help. Boy I'll be glad when these brain frogs hop on out of My head so I can think a little more clearly.
73 non ab 98 hep c refused pegint/riba
6-15 Gen.1b 1/2 MIL ALT72 AST37 No cirrhosis
7-15  Harvoni 12 weeks
10-14-15 EOT VIRAL LOAD NON-DET  
12-30-15 EOT+12 VIRAL LOAD NON DET  SVR12            8-9-18 HCV LOAD 1.02IU/ml AST22  ALT30 RELAPSE?
9-18-18 confirmed gt 1b relapse
10-16-18 approved 16 weeks Mavyret

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: UND?? I may have misspoke?
« Reply #12 on: August 15, 2015, 11:43:41 pm »
Totally understand DragonSlayer!

Great explanation!

thank you,

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

 


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