Thanks for the update Malcolm. I read your previous post as well. So does this mean the TMA tests should not still be considered the most sensitive? I was thinking if my next VL came back as UND I would ask (ask his thoughts, not request) my doc about getting what I thought was the more sensitive TMA to be sure. Now I'm wondering if I should. If they're not popular there must be some reason - is it just the cost or efficacy?
You don't have the object of the game down just right, It is not about getting rid of the virus completely It is about getting it so low you can fight it, A healthy person will clear it -self without the aid of the drugs and that is what we are trying to cause, the question is ware do you draw the line, 43, 5, ?? all those are vary low, I don' t know how low it has to be till yorself can clear it. but I bet is is a low number like 5, or 43,.
mallani said
Jul 28, 2014
Hi pw,
TMA tests have never been done is Australia. When I asked my Lab. about them, I was told they are very expensive and time-consuming, and there's a question mark about accuracy. They had surveyed the Hepatology doctors, and they were happy with the PCR test down to <15 LLOQ.
A couple of years ago, many Forum members used Heptimax (Quest- LLOD down to 5). We don't see many posts using TMA anymore. I'm not sure of the cost in the USA, and I wonder whether the accuracy has been questioned. Ask your doctor- he will probably be happy with a PCR test. Cheers.
patiently_waiting said
Jul 28, 2014
Thanks for the update Malcolm. I read your previous post as well. So does this mean the TMA tests should not still be considered the most sensitive? I was thinking if my next VL came back as UND I would ask (ask his thoughts, not request) my doc about getting what I thought was the more sensitive TMA to be sure. Now I'm wondering if I should. If they're not popular there must be some reason - is it just the cost or efficacy?
Josh Haynie said
Jul 28, 2014
Thanks Malcolm :) have a good monday
mallani said
Jul 28, 2014
Hi all,
With the increased availability of on-line portals for test results and Tazkat's recent post, it's worth revisiting what your report means. There's a 'Sticky' on this, but some things change.
Most Labs now use a PCR Test from Roche or Abbott. The TMA tests from Quest and Labcorp do not seem to be as popular. The LLOQ (Lowest Limit of Quantification) is usually 15 i.u./ml, and this should be stated on the result form. In Australia, the LLOD has been dropped.
The test uses a 'target' which is a highly conserved section of the virus from the UTR (Un-Translated Region), and the result measures the number of 'targets' in a ml of blood. This 'target' is present in the wild-type virus , all polymorphisms and in all Genotypes. Each 'target' represents a viral particle, but for some unexplained reason, the result is reported in i.u./ml. Depending on the Lab. or assay, one i.u. could equal between 1-5 viral particles. Crazy. Results using Log. values have mostly disappeared, but are often still given as well.
By convention, an Undetected result will read <15 i.u./ml Undetected or Target Not Detected (TND). Any other result is assumed to be Detectable but not quantifiable.
My Lab. has recently changed this to read <15 Positive or Negative. When I asked why, I was told this was a directive from the Australasian College of Pathologists.
The definition of a 'high' VL is now >1 million i.u./ml.
So, in summary, read your result carefully, and get a copy of the report. Cheers.
You don't have the object of the game down just right, It is not about getting rid of the virus completely It is about getting it so low you can fight it, A healthy person will clear it -self without the aid of the drugs and that is what we are trying to cause, the question is ware do you draw the line, 43, 5, ?? all those are vary low, I don' t know how low it has to be till yorself can clear it. but I bet is is a low number like 5, or 43,.
Hi pw,
TMA tests have never been done is Australia. When I asked my Lab. about them, I was told they are very expensive and time-consuming, and there's a question mark about accuracy. They had surveyed the Hepatology doctors, and they were happy with the PCR test down to <15 LLOQ.
A couple of years ago, many Forum members used Heptimax (Quest- LLOD down to 5). We don't see many posts using TMA anymore. I'm not sure of the cost in the USA, and I wonder whether the accuracy has been questioned. Ask your doctor- he will probably be happy with a PCR test. Cheers.
Thanks for the update Malcolm. I read your previous post as well. So does this mean the TMA tests should not still be considered the most sensitive? I was thinking if my next VL came back as UND I would ask (ask his thoughts, not request) my doc about getting what I thought was the more sensitive TMA to be sure. Now I'm wondering if I should. If they're not popular there must be some reason - is it just the cost or efficacy?
Thanks Malcolm :) have a good monday
Hi all,
With the increased availability of on-line portals for test results and Tazkat's recent post, it's worth revisiting what your report means. There's a 'Sticky' on this, but some things change.
Most Labs now use a PCR Test from Roche or Abbott. The TMA tests from Quest and Labcorp do not seem to be as popular. The LLOQ (Lowest Limit of Quantification) is usually 15 i.u./ml, and this should be stated on the result form. In Australia, the LLOD has been dropped.
The test uses a 'target' which is a highly conserved section of the virus from the UTR (Un-Translated Region), and the result measures the number of 'targets' in a ml of blood. This 'target' is present in the wild-type virus , all polymorphisms and in all Genotypes. Each 'target' represents a viral particle, but for some unexplained reason, the result is reported in i.u./ml. Depending on the Lab. or assay, one i.u. could equal between 1-5 viral particles. Crazy. Results using Log. values have mostly disappeared, but are often still given as well.
By convention, an Undetected result will read <15 i.u./ml Undetected or Target Not Detected (TND). Any other result is assumed to be Detectable but not quantifiable.
My Lab. has recently changed this to read <15 Positive or Negative. When I asked why, I was told this was a directive from the Australasian College of Pathologists.
The definition of a 'high' VL is now >1 million i.u./ml.
So, in summary, read your result carefully, and get a copy of the report. Cheers.