Hep C Discussion Forum

Congrats, Mike! Undetected and end of treatment, that's two things that are music to our ears. Thanks for telling us about the first test results that were so confusing. It's not uncommon to have a detected result that's too low to quantify. That means the viral load is below the LLOQ or Lowest Level of Quantification but still picked up a viral straggler. As we discussed, by the time you found that out, your continued treatment had successfully destroyed those viral remnants and you were likely undetected. It's a mute point now however! Well done...

12 weeks after your end of treatment you should be scheduled for one last set of tests to confirm you remain undetected, at which time you are considered cured. We call it SVR12 or a sustained viral response, week 12 after end of treatment. I would start planning an even bigger celebration now!

WOOT!!

Agree - I don't like the way they provide this lab info either (not how it is laid out nor the lack of clarity).

Just have to take it at "face" value.

Under heading of "RANGE" - (column 5) everything listed vertically under this, is what you should be, to be within "normal" limits

Under the heading of "VALUE" (column 3) - everything listed vertically under that, IS what YOUR results are.

So, on this page just ignore completely the words "not detected", that is just what "normal" is.

All I can glean from this, is that YOUR result IS - 1.08 IU/mL, and 1.08 IU/mL converts to 0.1 log as I figure it. (If your result had been expressed as 1.08 log then that would convert to about 10 copies/ml.)

Phone the lab and/or the doc to get them to elaborate (clearly) with better words than what this report provides you.

But we all agree, you have crashed your load to smitherines, you should party NOW! Your LFT's and bloods are wonderful, you are doing stupendously!  C.

BTW- I also agree with Tig, it is always a surprize to still see differing labs using differing normal references ranges (especially for ALT's), you'd think we would have got it together by now, globally, with the "units" of measure and the "ranges"!

I sure don't like the way they list the results of the viral load. First of all, the Undetected reference they have on both your test reports isn't your result. It's the normal reference for someone without the virus. Your results back in February with the Log of 6.45 IU/ml, puts you in a range of 2.75 to 3.0 Million viral copies. That's considered a medium level viral load, as compared to low or high. Doesn't matter what the viral load is these days, except some protocols will allow you a shorter duration (ie 8 weeks vs 12). Harvoni is one such protocol. But that is decided by your doctor and various other tests prior to starting Tx. 

With that said, and without the inclusion of UNDETECTED adjacent to the Log number leaves much to be desired with your report. But I will tell you that from years of experience, the most recent result of <1.08 IU/ml log, does indicate you are below the level of quantification and most likely are indeed undetected. It's pretty rare these days to have that significant of a viral drop (below the LLOQ) and not be undetected. I would ask for better clarification from the lab and doctor on future tests and tell them why. See if you can get a paper copy of the actual test result from the lab for your records. I don't understand why they place that kind of information on a portal without it being completely clear. In a perfect world you know....

One other thing I noticed was the reference range of the ALT. Holy smokes, their normal says it can be anything <79! That should be something far less, but again, different labs have different reference ranges. They have been revising those reference ranges lately to bring them together around the globe, but there's still no set in stone standard. Look at this graphic and you'll get a better idea of what I mean. Doesn't matter in your case, because both your AST and ALT are stellar and quite good. I personally believe the lower the better and we see levels far below the lowest level indicated on these new revisions. JMHO

Reference Range(s) New and Revised:   (19-25 IU/L [for women], 29-33 IU/L [for men])    New Guidelines

Don't be concerned with any of it, you're doing great and by now you're clear of the virus and now you're in the mop up stage. Now the important part of the process is length of treatment. You want to continue as prescribed so all tissues in your body are exposed to the drugs. They work their way into all the hidey holes in your system and root out the stragglers. It's how these treatments work. Some people get that first undetected result and think they can quit, WRONG! It's the overall exposure time that assures your success. 

Hi ninja,

When in doubt, there is no substitute for all eyes reading the same page to glean the  nuances, key words, clues - is there any way you can post the report(s) in question (with personal identifying data removed)?

Aside from any additional words/numbers on your report ...  does your report have any indication of what "machine/process" they used, words like:  "Abbott ...", or it may show something like ..."COBAS AmpliPrep TaqMan"... Do your reports have any other words on them like these - indicating the test method they are using? Aside from showing the actual report as written, knowing the test process they used might reveal things more clearly. Just thinking.  Regardless of how hard it is to interpret lab test results sometimes - just know YOU ARE doing super! - just as is destined and inevitable on the likes of epclusa - you have CRASHED your VL, your ALT/AST and bili look good (although we don't know for sure how "much" they crashed yet, only because those old ALT results are just not available to you yet) - I bet your ALT crashed too, right along with your VL - and all this at just 4 weeks!!!!!!!! You got it made. Don't fret. I must be like you, I like to get all the details figured out. C.

Here's an excerpted Q and A, written by Lucinda Porter in 2015 (talking about load tests).

Q: "What does this test mean?" This question is accompanied with test results such as:

HCV Viral Load (Log IU/mL)   <1.18 not="" detected="" o:p="">

A: Undetectable means that hepatitis C is gone, and presumably all gone. The confusion over this test is because viral load tests don't measure down to zero. Further, viral load tests vary. For instance, the Abbott RealTime HCV assay (assay is a fancy word for a test that determines and measure the ingredients of something) measures down to 12 IU/mL in a 0.5 mL sample of blood. This means that if you have 12 IU/ml of hepatitis C (HCV RNA) in your blood, the test will detect it and count it. If you have less than 12, the test might not see it, and if it does, it won't be able to count it.

Each test has its own detection range, some lower than others. The main thing is this:

"Not detected" = negative for hepatitis C

"Detected" or an actual number of how much HCV RNA you have = positive for hepatitis C

Is there another reference number adjacent to the <1.08? That's the log number, which is another way they refer to the viral load.  If you had a detectable viral load, it would say DETECTED. Some labs will simply list the undetected viral load with a < (less than) figure. Some labs list their results differently and without seeing the actual form, I can't tell you how yours documented it. If you are below the LLOQ or lowest level of quantification and it doesn't say DETECTED, you are indeed undetected, congratulations. Your AST/ALT/Bili numbers are fantastic!

Only 9 days left before I'm finished! 

I do have a question though. My last blood test from the beginning of July came in and my viral load said <1.08 IUnits/ml. I know that means it is less than 12 but is that just a fancy way of saying, "we're not exactly sure what your viral load is" or is that as low as they can accurately detect it? 

I was also able to find my ALT/AST/Bili this time was 23/16/0.4

Still don't know ALT/ASTs. Do they get that from a blood test? If they do then I'm sure that'son the papers somewhere. 

Im starting to feel a lot better and look a lot better as well. I gained a healthy amount of weight. I was around 135 lbs. When I started treatment which was the lowest I have been since high school. Now I'm at 160 which is good since I started to lose weight fast right before I started Epclusa. No more bags under my eyes. I can eat a lot more. I'm not sure if that was all from Hep C but it seems like it was at this point.

Hey ninja,

What great news! Been wondering how you were making out on that wonder-drug called epclusa! Very, very well indeed we see. Only a couple of headaches, well, you must have been keeping well hydrated then. I am so glad you are feeling OK and responding so well. That seems to be the powerful nature of epclusa and these marvelous new DAA's - they are working so well to cure us nowadays - it is a whole new world for those of us lucky enough to get these new drugs, it was such a struggle before, with the old drugs (and that was not so very long ago!)

I count my lucky stars, every day, for my treatment with these new DAA's.

I am so pleased for you.

Did you happen to find out what some of your pre-treatment ALT/AST's were, and what your current ALT/AST is now? Just curious, they usually drop (crash) too, just like your VL has done, so well!  C.

Welcome to the Forum Mike.

JimmyK

Hi Patricia,

Welcome to the forum! I see you just started Harvoni this week. Can you do me a favor and start your own thread? This section was started by CodeNinja and his journey on Epclusa. We don't want to hijack his thread. You can start a new one in this section or use the Harvoni Train, (below) it's more of a community thread. You can also introduce yourself and tell us some history by starting a new post in the New Members section. There are colored links in my signature to help you set up your signature line. It helps us when replying.

Use our Home page and the search function. We have a lot of good information here. When you can, list your Genotype (1b) and any lab tests you have. Your signature line is a good place to put them. The most important part of this journey is to stay compliant, don't miss a dose and drink at least a gallon of water EVERY day! Stay rested, eat right and you'll be celebrating in no time!

Harvoni Train

Hi ninja  on Wednesday I will be half way through my Epclusa treatment of 12 weeks. I felt the same, normally gagwith big tablets but so relieved when I got to take first one...and since they go down easily....my first one was quite an emotional moment and setting my alarm ringtone to remind me its 'Epclusa time'.....I still jump with excitement when it's that time....knowing I'm another day done. This treatment worked so quickly in terms of making me feel better...we are lucky...life is good ...and the lovely Canuck has been an inspiration to me ...well wishes xxx

Jaggles