Standard EOT blood tests?

[DeathtoHep]

Ok, this is my second post regarding viral load testing. My doctor does not test for it until EOT and 24 weeks later. I talked to my nurse from Proceed (im on viekira pak) because she knows everything by the book supposedly. She basically said undetected 12 weeks after EOT is considered cured but my doctor wont test for it. I even tried to argue with him which ofcourse got me nowhere. He wont give me a viral load test during treatment which I can deal with because I can see its working by my liver functions. But even this is not up to the medical standards hes supposed to be upholding and from what I can see on this site is not typical.

My problem with waiting 24 weeks is I shouldnt have to wait and wonder whats going on with my disease when I can know for sure if Im cured at 12 weeks. That, and I have a bunch of other medical conditions that need attending to and Id rather not start on something new before this is finished completely.

Obviously I want to do what my doctor says but this is the second time ive questioned his credibility. Is anyone else in this situation? Should I push again for the test or ask my primary doctor?

[gnatcatcher]

Hmmm, if you ask your primary doctor, and s/he orders the VL test, would your specialist see the result, either through electronic records or some protocol that has the primary doctor automatically informing the specialist? If the specialist hates being crossed, you might have to get your primary doctor to order the 24-week post VL, too. That's the worst-case scenario I can see, and it doesn't seem insurmountable.

The only other possible down side I can think of is if your insurer has a rule about how frequently it'll pay for a VL, which could leave the bill in your lap. But you can find that out ahead-of-time.

[Cal]

Deathtohep,
In Aussie, we are allowed 4 V/L tests per year. So I had one before, one at 2 weeks, will have one at EOT and will also 12 weeks later. I see some of your compatriots also have an eight weeker. I think Gnats right. I'd go primary GP and get an EOT wh, unless there is an issue with your insurer of course. But for peace of mind, I'd definitely not worry about putting the specialists nose out of joint. Cal 

[GLCII]

Deathtohep

Don't worry about your specialist. You want to know if your user name, Deathtohep, holds true or not. It's your life, your health and your insurance. If your insurance is willing to pay to have a test done, get your primary have the test done for you. There's also nothing that says you can't pay for it yourself! Don't worry about your specialist seeing it. There's no reason you should have to wait 24 weeks for results you should have at 4 & 12 weeks post TX. Making a person wait 24 weeks for the first post Tx blood test is tantamount to psychological torture considering a person wants to know asap if this new treatment worked or not. I think most of us were anxious to get the 4 week post test done considering its predictive value. He/She could have at least ordered that.

It's weird how different doctors seem to have different standards. My doc, a Gastroenterologist/Hepatologists who works at the hospital, where the blood is actually tested, had me checked every two weeks during Tx and then at 4, 12 & 24 weeks post.

In my mind, the minimum testing, based on a 12 week treatment, should be, 1 test at the start of Tx, 1 test 4 weeks into Tx and another test at EOT. Then it should be 4 weeks post EOT and another at 12 weeks EOT with an opton of another at 24 weeks EOT seeing how they're now considering SVR12 the cure. A person doing a 24 week Tx should probably have that adjusted accordingly.

But that's my thought. 

[dragonslayer]

>> He wont give me a viral load test during treatment which I can deal with because I can see its working by my liver functions. But even this is not up to the medical standards hes supposed to be upholding and from what I can see on this site is not typical. <<

Deathtohep, with today's DAAs, on-treatment testing is really not part of the protocol.  However, testing at 12 wks is.   I was in your shoes for a short time.. My doctor told me to test 6 mos post treatment.  At end of treatment, though I couldnt  bear the wait, so I called up the office, spoke to his nurse (I can never speak to him directly as hes always busy) and told her Dr. XYZ must have forgotten to order me the EOT test.   She said shed fax me the lab request which she did.  When it came back detected, I had no problem getting another lab req at 7 wks..  I would make copies and whenever I wanted to test, I presented the copy of the lab req to the lab, and it went smoothly. Ive had my 24 wk test (UND), and in a couple of months, Ill do my final, 48 wk test... Odds are way under 1% that the 48 wk test will NOT be UND, so I might skip it as I have a physical scheduled in January with my PCP.. If the liver function tests are normal at that point, Ill forget about the final test; if theyre not, Ill have the lab do that test in that contingency.

A lot of doctors seem to be laboring under the old Interferon treatment regimen protocols for testing.  In your case, he dispensed with the old de-rigeur on-treatment testing, but is still using the old 6 mo post treatment marker for SVR.  See if you can get anywhere with his nurse(s).