Aa
vl testing timing changes?
I have recently noticed some people getting vl tests done earlier than what my Dr is doing them. Some with inc at 2wks. Is it insurance not wanting to pay, or protical begining to change? I would love to know what my vl is doing between wk 12 and 24. Then there is the long haul for some of us to wk 48. I really feel like if I have had a viral breakthrough I would like to know that before I endure several more wks of tx. Its a posibility I have been misdiagnosed in the past and dont know what to think anymore. In fact I cant hardly think anymore!!! LOL My original Dr once told me I had a breakthrough, as I was und during tx, and then det again while still on tx, but he is now deceased. My records are an indicator of how much change has taken place in 10 yrs. No vl test at all for 28wks then. I could have been und at some point and didnt know it. I have seen that posted on here before, in that case would my classification be different than null? if so what would it be? Man I can take bad news better than no news.
slideman
I am all for asking the doctor for an extra test. I think in your case, where a breakthrough might be a concern, it would be a good idea. I asked for a 6-week test (2 weeks on VIC) and my doctor wrote out the order. I have also, since I have become UND, asked to change from HCV RNA RT to LabCorp Quanta Sure - again, to confirm that I have no virus with the lowest test available. He has honored my request on that too and sent all new labs. I have another friend (no names given) who made copies of the orders and just took the same orders to the lab eveery week and got PCRs.
We have to be creative!
I am all for asking the doctor for an extra test. I think in your case, where a breakthrough might be a concern, it would be a good idea. I asked for a 6-week test (2 weeks on VIC) and my doctor wrote out the order. I have also, since I have become UND, asked to change from HCV RNA RT to LabCorp Quanta Sure - again, to confirm that I have no virus with the lowest test available. He has honored my request on that too and sent all new labs. I have another friend (no names given) who made copies of the orders and just took the same orders to the lab eveery week and got PCRs.
We have to be creative!
I had a VL done at 4 weeks. It was detectable at <43. Therefore, my doctor ordered another VL at 8 weeks (because I was detectable at 4 weeks). If I had been UND at 4 weeks, the next VL would not be drawn until 12 weeks.
I had mine done at 4 weeks, to low to detect. Then again at 6 weeks and he tells me its gone. supposed to have another one at 12 weeks. I know but sometimes no news is good news..Good luck God Bless
i had my vl checked at week 1, week 2, week 4, week 8, and week 12. but that's what they do in study trials. don't know about insurance. take care, belle
My Dr seems to like to stick to protocol. I think they are so overwhelmed with tx patients they have no time for anything extra. I have found a lot of things to be very contradictory with Dr almost every visit. I would think maybe its just my foogy head, but my wife comes with me and she sees it too. Maybe I should be more forcefull but then they think your just haveing sides and want to put you on meds.
I'm glad you are seeing the results going your way!!
I'm glad you are seeing the results going your way!!
So of us are on trials and VL is checked more frequently. I have all my info. in my profile for folks to see as it seems redundent to enter it on all posts. Best of luck.
Laboratory Tests
HCV-RNA levels should be monitored at weeks 4 and 12 and as clinically indicated. Use of a sensitive real-time RT-PCR assay for monitoring HCV-RNA
levels during treatment is recommended. The assay should have a lower limit of HCV-RNA quantification equal to or less than 25 IU/mL and a limit of
HCV-RNA detection of approximately 10-15 IU/mL. For the purpose of assessing response-guided therapy eligibility, an “undetectable” HCV-RNA result
is required; a confirmed “detectable but below limit of quantification” HCV-RNA result should not be considered equivalent to an “undetectable” HCVRNA
result.
Hematology evaluations (including white cell differential count) are recommended at weeks 2, 4, 8 and 12 or as clinically appropriate thereafter.
Chemistry evaluations (electrolytes, serum creatinine, uric acid, hepatic enzymes, bilirubin, and TSH) are recommended as frequently as the hematology
evaluations or as clinically indicated [see Adverse Reactions (6)].
http://pi.vrtx.com/files/uspi_telaprevir.pdf
That is the testing protocol of vertex, your doc is probally following protocol for PCR testing and they are expensive test so the insurance co may well have something to do with limiting testing to follow vertex protocol hard to say. If you want more test try requesting them and see what they say
HCV-RNA levels should be monitored at weeks 4 and 12 and as clinically indicated. Use of a sensitive real-time RT-PCR assay for monitoring HCV-RNA
levels during treatment is recommended. The assay should have a lower limit of HCV-RNA quantification equal to or less than 25 IU/mL and a limit of
HCV-RNA detection of approximately 10-15 IU/mL. For the purpose of assessing response-guided therapy eligibility, an “undetectable” HCV-RNA result
is required; a confirmed “detectable but below limit of quantification” HCV-RNA result should not be considered equivalent to an “undetectable” HCVRNA
result.
Hematology evaluations (including white cell differential count) are recommended at weeks 2, 4, 8 and 12 or as clinically appropriate thereafter.
Chemistry evaluations (electrolytes, serum creatinine, uric acid, hepatic enzymes, bilirubin, and TSH) are recommended as frequently as the hematology
evaluations or as clinically indicated [see Adverse Reactions (6)].
http://pi.vrtx.com/files/uspi_telaprevir.pdf
That is the testing protocol of vertex, your doc is probally following protocol for PCR testing and they are expensive test so the insurance co may well have something to do with limiting testing to follow vertex protocol hard to say. If you want more test try requesting them and see what they say
I don't know why, but my NP had the viral load checked after one week. I also just had another viral load drawn yesterday. I see her next Wednesday beginning of week 4. My VRL has already dropped from 3.6 million to only 683. While not Und, it is going in the right direction.
Why not ask your doctore to order another VRL?
Why not ask your doctore to order another VRL?
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