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Main Forums => Living With HIV => Topic started by: livingpositively on July 06, 2006, 08:09:32 pm

Title: Labs are in, but...???
Post by: livingpositively on July 06, 2006, 08:09:32 pm

I got my 2nd set of lab results today.  ??? ??? ???

Drawn 6/23/06 midafternoon:

CD4 530
CD4% 29
VL 83,800

First labs were drawn 3/23/06 midafternoon:

CD4 555
CD4% 28
VL 13,000

So YAY!!!, my % went up.  CD4 count, although less, probably insignificant.  VL...ouch...but I realize not a "WTF amount".  So, I'm ok with this......for now.   :-\

My question is the first VL test was PCR and this last one was "HIV Ultra Sensitive".  Is the "Ultra Sens" the same as bDNA?  Does anyone know.  And if that's the case, because the PCR apparently returns a VL double that of the bDNA, then I'm kind of saying, "WTF?!".  Doc doesn't seem too terribly concerned about it, and I know with only two draws, I haven't been able to establish a trend etc, etc, etc.  Really just wondering if anyone knows if this ultra sensitive test equates bDNA.

Thanks all,

Shane

Title: Re: Labs are in, but...???
Post by: newt on July 06, 2006, 08:27:49 pm

There's 3 types of viral load test:

* Reverse-transcriptase polymerase chain reaction (PCR) test
* Branched DNA (bDNA) assay test
* Nucleic acid (NASBA) assay test

Ultra sensitive will probably refer to a PCR test that counts down to 50 copies or less. But it could, eg mean a bDNA test like the ultra-sensitive Quantiplex 3.0 or sommat. Ask.  It's important because a straight comparison test on test really needs the same (kind of) assay each time.

Vira load on PCR varies by a factor of 3 so your 2 VL results could easily mean a level number.

- matt

Title: Re: Labs are in, but...???
Post by: livingpositively on July 06, 2006, 10:15:06 pm

Thanks, Matt:

I didn't realize that there were two separate PCR tests, one just being more sensitive than the other.  If that's the case, I feel much better.  I will definitely be calling my doc tomorrow to get that clarified.

Thanks again,

Shane

Title: Re: Labs are in, but...???
Post by: lydgate on July 07, 2006, 01:44:04 am

There are many versions of PCR VL "assays" -- some used in research labs are ultra-ultrasensitive and can detect down to 1 copy. The two most commonly used commercially have detectability thresholds of 400 copies and 50 copies respectively; so "undetectable" means something different depending on which test has been used. The 400-threshold test is cheaper, so if that's an issue, and if you're not going on HAART, you can stick to that one.

I agree that the CD4 difference is not significant at all. But the VL is greater than three times your previous result. Were you experiencing a transient infection at the time the blood was drawn (like a cold) that could have affected the results? All in all, though, these are good, solid numbers. What you've told yourself about only two blood draws and trends is bang-on; I wouldn't worry.

Jay

Title: Re: Labs are in, but...???
Post by: Ann on July 07, 2006, 04:10:22 am

Shane,

Don't stress that VL too much. Mine have been all over the place since I've been monitored. They've never been over 50-60,000 something, except for one time when it came back at 90,000 something. Turns out that time they were using a different test that time. Your CD4 and % are great and you could go for years without meds on numbers like those - I have. Nine years now, to be exact. Hang in there!

Ann

Title: Re: Labs are in, but...???
Post by: livingpositively on July 07, 2006, 11:00:44 pm

Thanks Jay and Ann,

I'm working on not stressing the vl too much.   :)  I have read enough on here, thanks to eveyone's generosity of self in sharing their stories and experiences, to know that little "shit" happens here and there and I don't have enough labs to have established any trends - and that seems to be what's important.

These forums not only provide a family and support network, but what an education as well.  Thanks all.

Shane