Viral load results

[Rickshaw]

Hi all,I am a little bewildered about the results received on last two hcv rna.
HCV RNA test. It is a PCR quantitative test. Any input would be helpful.thanks

Component 1/26/2015 2/26/2015
HCV RNA INTERPRETATION SEE NOTE SEE NOTE

1/29/2015
Component Results
Component
HCV RNA INTERPRETATION
SEE NOTE
Comment:
HCV RNA Not Detected

3/2/2015
Component Results
Component
HCV RNA INTERPRETATION
SEE NOTE
Comment:
HCV RNA Detected-Not Quantifiable when <20 IU/mL


Here are your Viral load results from 3/16/15:
HCV RNA INTERPRETATION
SEE NOTE
Comment:
HCV RNA Detected-Not Quantifiable when <20 IU/mL





   

[dragonslayer]

Rick,

There have been  numerous threads and posts lately on how to interpret viral load tests and Id start there first.   Generally, when asking for help, you should give some information about your case such as that seen in many of the forum signatures which members use; it's hard to answer any specific HCV questions without the requisite context.  Also, when posting test results, it would help to indicate which test was used, ie was it the Cobas Taqman, the Abbott real time assay, or one of the others (the test result usually contains this info).

Superficially, when your result is listed as 'detected' but not 'quantifiable' it generally means the result is below the Lower Level of Quantification for that test meaning there was too little of it to produce a quantifiable result which is why you dont have a number or viral load on your tests.  That is generally a good sign.  Gilead used results that were lower than 25 as being successful for the test they were using in their Harvoni trials.  That aside, I think that the most puzzling aspect about your test is why was it undetected, and then a few wks later, detected, and i dont have any answer to that;  how does your doctor interpret it?  ... What is your treatment, how long is your treatment, when did you start and what was your pre-treatment viral load, what is your hcv history, what is the condition of your liver, etc, etc, etc.

Id refer you to this thread which has an awful lot of information regarding HCV testing and how to interpret:

http://forums.hepmag.com/index.php?topic=2413.0

Best of luck to you.

[coloradogirl]

I go in for my 4th week blood tests tomorrow, so to make sure things go smoothly, I checked to see if it made a difference in what test is used, and what lab can perform the test I require.

My doctor ordered a Nucleic Acid Direct Probe (87520), an HCV-RNA by RT-PCR, reflex to TMA, which is sensitive down to 10 (with some sources indicating 5-10 in sensitivity).

The KP lab initially used a Cobas AmpliPrep/Cobas TaqMan HCV assay, which is sensitive down to 15. Quest uses the TMA test ordered. So I wondered what the need for the TMA test is all about.

I finally found something difinative on the Quest Lab web site that clarified the procedure they use. They test the sample using the TaqMan assay, and if it comes out below 15 then they perform the TMA test for the finest results of quantifiable virus load. They send the blood work to their lab in Chantilly, VA where specialists conduct the TMA test.

The TMA test is costly and not paid for by insurance, but the results could make the difference for me to opt for addition of Ribivarin for the last 8 weeks. From what I have read, it can also determine whether to prolong treatment for some patients,  or cut a 24 week treatment to a lesser duration.

I am curious what tests have been ordered for you all. Are there any like what have been ordered for me? 

[Rickshaw]

Kaiser in Bay Area uses the regional lab in Berkeley.Im not sure which one it is.My week 4 was ud.Week 8,11,12 all came back as HCV rna detectected not quantifiable when less than 20.hmmm.i will do another Vl in a month and hope for best.if it comes back the same I'll have one out of pocket at Stanford.i did 12 weeks harvoni and Ribavarin and finished Monday.I hope all goes well for you on your labs and treatment.

[Lynn K]

I go to lab corp for the HCV RNA by PCR reports results down to 15 IU/mL. I was tested at 4 weeks and 12 weeks on treatment and won't be tested again until week 24 EOT then 12 weeks post for SVR12 check

These are the notes on the test report from Lab Corp

The quantitative range of the assay is 15 IU/mL to 100 million IU/mL
using COBAS(R) TaqMan(R) HCV test, v 2.0. The limit of detection (LOD)
and lower limit of quantification (LLOQ) for this assay is 15 IU/mL.
Results less than the quantitative range of the assay will be reported
as "HCV RNA detected, less than 15 IU/mL".

Good luck on treatment

[Rickshaw]

How and where do they have these.im in Bay Area ca.id be willing to pay as kaiser does not have this.thanks.

[coloradogirl]

Rickshaw,

The test my Dr. ordered is under the 87520 CPT code. Quest doesn't list that code specifically, but one similar to it is the 87522 (test code 10051) listed at Quest diagnostics. http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=10051&labCode=AMD

The sample is sent to the Chantilly lab in Va. where specialists conduct the test. I don't know what the pocketbook damage is yet. I'm glad they do the less sensitive test to 15 first, before they do the this one.

I am surprised your KP uses one that goes to only 20 and not the 15. My KP did the Cobas AmpliPrep/Cobas TaqMan HCV assay, which is sensitive down to 15. What does your doctor have to say about the different tests?

[coloradogirl]

And, Rick, I hope the next test results for you show undetected.

[dragonslayer]

Rickshaw,

The test my Dr. ordered is under the 87520 CPT code. Quest doesn't list that code specifically, but one similar to it is the 87522 (test code 10051) listed at Quest diagnostics. http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=10051&labCode=AMD

The sample is sent to the Chantilly lab in Va. where specialists conduct the test. I don't know what the pocketbook damage is yet. I'm glad they do the less sensitive test to 15 first, before they do the this one.

I am surprised your KP uses one that goes to only 20 and not the 15. My KP did the Cobas AmpliPrep/Cobas TaqMan HCV assay, which is sensitive down to 15. What does your doctor have to say about the different tests?

Did you know the Gilead trial numbers for SVR were based on a test that had an LLOQ of only 25?!