Jim - Heptimax

[Myown]

Hey Jim,

Hope all is well. I have a question.  Okay, so to refresh your memory - UND since week 3
and will be doing shot 16 (?) this week, but anyhow shot #9 was <50, but when
reflexed was "60 vl". So needless to say I felt that electric bolt sensation go through my body
upon hearing that.

My doctor was not worried or concerned, figures its contamination. Got an opinion
of another member who agrees with my doc. It sounds logical it could have been contamination because
next test was UND and I would imagine it would have continued to climb if it was breakthru (?) But of course
going through the 24 weeks last year and never having a false positive makes me question if it was really
contamination or was it a real VL.

Would they have been able to re-test the blood in that vial?  

So, if you have any thoughts, opinion or advice - I'd appreciate it.

Thanks,
MO

[jmjm530]

Personally Id call --or hv my doc call -- and ask for clarification> Could be a typo. If customer service cant heslp speak to a supervisor or the lab directo> Would not let that one slide. Also Id still retest using the one suggested> BTW I think you are going to do yourself more harm tha good with another 72 weeks regardles of results> You dont hv a lot of damage and that would be close to a hundred weeks of interferon total> Personally Id either listen to your doc or if you believe you really wont clear in 48 weeks then cit your losses and quit. You dont want to destoy your whole body trying to kill a virus that may not be doing you too much harm right now

[Myown]

Thanks Jim,
Yes, it was confusing to me too because I wondered why it would be reflexed if it wasn't under the 50....

Here is exactly what it says...

Component HEPTIMAX (R) HCV RNA (Panic):   (the word "panic" really is there too)

TMA                          61                             <5   IU/ml

"Because the HCV RNA level was below 50 IU/ml using Real - Time PCR method, the sample was further assayed using the transcription-mediated amplification (TMA) method"
TMA                        1.79                             <0.70 log IU/ml


..........(test performed at Quest Diagnostics Nichols Institute)


But anyhow all my eyes went to was the "61" and I said 'you've got to be kidding me,
you didn't call me!"  Why wasn't this re-tested etc......I was told no need to worry, its contaminiation etc.

But here's the thing, I have never seen it written up like this. It always has the
<50 first and then if its under, it then shows the <5 on the next line.

I don't know why this just showed the TMA FIRST and then had written below it that they did the <50 and it was below and used the TMA etc


So anyhow I had decided this year instead of stressing out and emailing or calling for my results, I would just assume that I was UND as long as I didn't hear from them because that is how they wanted it last year and always said they would call if a problem. My argument always was yeah but anyone can make a mistake , I don't want to slip through the cracks. No you won't etc.....So I cut some slack and now my husband has learned why I don't ever cut slack and why I insist on things.....IMO the blood should have been tested again or at the very least, call me as soon as results came in to do the test again. But instead I didn't learn of this until my next appointment, which would be 4 weeks since the "60.'  So now I think I am going to push for 72 weeks. I had asked for that before this incident, and the doc doesn't see the need, but now maybe I have more of an chance. Whats the sense of going through the 48 and the taper off and then relapse again, only to then do 72 weeks. May as well do 72 weeks NOW and then if that don't work, then that's it and I can wait until we are driving cars like George Jetson cause I heard thats when the new studies for geno 2 double relapsers are coming out :o)

So thats the story. Good to talk to you Jimmie,
Thanks again,
MO

PS,,,,,I do always get the blood draw the day of (right before) my shot- learned that from you my first round of treatment.

[jmjm530]

Something strange because when Heptimax "reflexes" to a quant TMA, the quant TMA has a range of 5-50 IU/ml. Therefore don't see how you can get a result of 60 IU/ml unless that is the PCR portion of the test. If it's the PCR (part I) of Heptimax then there would be no reflex. Capish?
-----------------------------------
As to re-testing the blood -- that would be an excellent thing to do but I doubt they would still have the blood. Time to do that would have been as soon as you got your result, but never hurts to call the lab, just doubt they would keep the blood that long and even if they did it may not be fixed properly for the TMA. Still do make that call...

As to whether or not it's contamination, let's hope that's the case...

BTW have you re-tested since week 9 when you got the "60" or whatever you got? I'd ask for another test pronto and the test I'd ask for is Quest's "HCV RNA TMA QUALITATIVE". It's a different test than Heptimax but has the same sensitivity of 5 IU/ml. I'd also make sure to have blood drawn the day before your next injection or the day of the injection but before the injection. And make sure you get hard copies of all your blood results. That way less confusion and mistakes when things get passed from doctor to nurse to patient, etc.

Hope everything else is going well. Good to hear from you!!!

-- Jim