Article on viral load interpretation

Question

Near the end of the article good news for those who are below the LLOQ but test shows detected at EOT

http://blogs.hepmag.com/lucindakporter/2015/03/new_hepatitis_c_trea_2.html

AWorriedMom · Accepted Answer

Lucinda is saying that even low levels of virus (not those just considered below the level of quantification) does not mean treatment failure in Harvoni patients. I believe that is true of Viekira Pak patients as well. This happened to a few in my trial. 

The only thing I disagree with is she writes of the Abbvie Assay  what undetected means, " This means that if you have 12 IU/ml of hepatitis C (HCV RNA) in your blood, the test will detect it. If you have less than 12, the test won't see it." When this happened in my clinical trial, our doctor called and spoke to the head of the laboratory and he explained that many times the virus is seen in people who are below the level of detection but not undetected. They just can't count below the level of 12. It reads like this <12 Detected. 

Bottom line though, is what Lucinda says, very low levels are nothing to be worried about.

Thanks for the article Lynn.

flyinlynn · Answer

I guess they are not totally sure wht you could have something like 25 detected and still go on to not have that viral jump back to the millions 12 weeks later but instead be UND even when you were not at EOT.

Either incomplete virus particles is one theory or complete virus but unable to replicate just waiting to die without children

Maybe, who knows. But in any event the real result we all want is SVR 12, SVR 24 and beyond just good to know just barely detected at EOT does not yet mean failed

neptune235 · Answer

Sorry, but the second paragraph above disappeared. What I intended to say was:

"Also, I've heard discussions in the past about a result of less than LLOQ but detectable being caused not by complete virons, but by RNA fragments  that are basically just pieces of virus."

neptune235 · Answer

Interesting about the chance of persistent low level viremia being extremely unlikely due to the replication rate in the 'trillions.'

Also, I've heard discussions in the past about a result of <LLOQ but detectable being caused not by complete virons, but by RNA fragments  that are basically just pieces of virus.

My main question is, if at EOT there is a quantitative result slightly above LLOQ, what is the mechanism for further viral suppression once the drugs are withdrawn?

flyinlynn · Answer

Yeah I agree that one bit could have been maybe better explained.

But the important thing being answered here that I know has freaked a few out (I know it would scare me) is seeing <12 detected at EOT and to know that result does not mean treatment failure.

The final answer is at the 12 and 24 week post EOT testing for SVR

Hopefully we will see the end of Hep c for all soon!

Lynn

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