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Author Topic: HIV Treatment guidelines and Blood draw time  (Read 1291 times)

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Offline John2038

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HIV Treatment guidelines and Blood draw time
« on: May 26, 2008, 02:13:20 AM »
Hi,

as many have already observed, the counts are changing a lot depending on the time at which the blood draw is made.

For example for this guy:
http://www.thebody.com/Forums/AIDS/Labs/Current/Q193038.html

CD4: 8AM ranges between 400 to 550. 8PM ranges between 750 and 1000
CD4%: between 48 to 54 percent

Same for me.

So the question: why the HIV Treatment Guideline do not standardize blood draw time to evaluate the CD4 ?

For e.g.: If CD4 < 350 8PM etc..

John

Offline Matty the Damned

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Re: HIV Treatment guidelines and Blood draw time
« Reply #1 on: May 26, 2008, 03:29:38 AM »
o.O

It's well known that variety of factors impact upon individual CD4 results. Such factors include the time of day. For this reason lab results such as CD4 counts are best viewed as trends over time rather than trying to derive some meaning from an individual result viewed in isolation.

MtD

Offline jportland

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Re: HIV Treatment guidelines and Blood draw time
« Reply #2 on: May 26, 2008, 04:54:24 AM »
I was diagnosed over 5 years ago... I knew then that the time of day that blood was drawn probably was a factor and was even told then that it was by doctors.... So what I did to make sure my trend was correct was for 5 years I scheduled my blood draws ALL with in an hour of each other... For 5 years I scheduled them took them between 2pm and 3pm..Always. If they couldn't get me in on the day I wanted between 2 and 3 I would pick another day.. And we watched and waited and after 5 years I went on meds and felt confident in my numbers becuz I had gone at almost the exact same time of day for years thus in the evaluating of them I felt that they were true in nature to what was going on in my body and that the trend was an honest one. I also waited until my Tcells were in the low 200's... They were there for quite sometime as well before i went on meds.( see my chart below).. It was due to my viral load finally going up that i went on meds in combination with my tcells as well but ....So if Tcells are higher at nite than morning and I took mine in late afternoon then I doubt mine were much higher at nite a few hours later and general guidelines are now to start at 350 and I started mine at 230 then I feel confident that I did not wait to long nor could I have waited longer either.... So for me it worked out well... Cuz if they really were a little bit higher at nite so be it cuz I still would have started them even if they were 100 higher at 350. But I had been in the low numbers for a couple years so... I doubt taking my tcells at 3pm vs 8pm ( a 5 hour difference) would have made THAT huge of a difference... and again you also need to factor in viral load... cuz THAT is what really prompted me to start meds in the first place as it jumped from the low thousands to well over 100 thousand... So to each their own.  But I waited as long as possible and I believe that I started at the rite time. Especially after reading that and bringing in all the equasions and such for me doin them all in the afternoon which would probably make them on the higher side and the fact that I took blood draws at almost the same time constantly makes me feel that it worked. How time flys but I made a consious choice years ago and thought that it WOULD matter what time I took blood draws and also that I should do them at almost the exact same time every time to get the most realistic number. And now it looks like there is proof that it could actually matter... Interesting... Glad I did it the way I did for so long as it may have paid off. Maybe and maybe not but I am glad I did it the way I did as it certainly made ME feel better in the REAL numbers of it. Also if you look at my chart below you will see that my number didn't change THAT much over 5 years and or that drastically... I wonder if they way I did it and by taking my blood at the same time everytime had something to do with it and maybe it is more accurate becuz of it?! Now that I have JUST started meds in March I think I will change my blood draw time to 4pm and 5pm everytime thus perhaps getting the highest number possible in tcells at one of the last possible appointments during the day for labs.
« Last Edit: May 26, 2008, 05:45:18 AM by jportland »
2001 tested neg
8/2002  seroconvert
9/2002 Tested Poz
No Meds
2/2003 302/25% 76K
9/2004 463/23% 14K
8/2005 342/22% 19K
7/2006 381/29% 24K
3/2007 386/34% 34K
3/2008 230/21% 269K
3/2008  Started Meds
7/2008 485/23% VL 140
9/2008 465/24% VL Undetectable
1/2010 581/29% VL Undectectable

Offline bocker3

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Re: HIV Treatment guidelines and Blood draw time
« Reply #3 on: May 26, 2008, 11:30:55 AM »
Hi,

as many have already observed, the counts are changing a lot depending on the time at which the blood draw is made.

For example for this guy:
http://www.thebody.com/Forums/AIDS/Labs/Current/Q193038.html

CD4: 8AM ranges between 400 to 550. 8PM ranges between 750 and 1000
CD4%: between 48 to 54 percent

Same for me.

So the question: why the HIV Treatment Guideline do not standardize blood draw time to evaluate the CD4 ?

For e.g.: If CD4 < 350 8PM etc..

John

Well, first, guidelines should not dictate a time, because it may not be possible for everyone to have their blood drawn at whatever time is arbitrarily decided.  Not to mention that this difference may not have much to do with the "time of day", but more with the person's own "body clock", so that a person who works the night shift may find their differences to be opposite of someone who works the day shift.

So, while it is true that an individual's CD4 level can be different at different times of the day -- the best way to control for that is for each individual to try and have their blood drawn around the same time.  My doctor has recommended that from the get-go and I think every doctor should.  I always get mine drawn between 8 and 9 in the morning.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Online Miss Philicia

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Re: HIV Treatment guidelines and Blood draw time
« Reply #4 on: May 26, 2008, 11:48:18 AM »
I've always been told to try and have my blood work drawn at the same time of day, on a relatively empty stomach.

Old news.
"Iíve slept with enough men to know that Iím not gay"

Offline hankgaguy

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  • Posts: 23
  • June2008
Re: HIV Treatment guidelines and Blood draw time
« Reply #5 on: May 26, 2008, 12:18:22 PM »
It's more the trend than the figures. I used to freak when I saw the CD-4 count increasing at a decreasing rate than the VL decline and then slight decreases (likely now due to the timing of the draws, I see, LOL).

I just look at the trends. I really no longer keep the results and track everything. No sense in numbers, just the trends and the faith that things will and truly get better.

I'm type AAAAAAA+, so if I were to track things, I would be a wreck, LOL.

Tim
Healthy, Happy, and Kickin' Butt

Offline aliveinla

  • Member
  • Posts: 247
Re: HIV Treatment guidelines and Blood draw time
« Reply #6 on: May 26, 2008, 12:47:36 PM »
my doc didn't tell me any of these but i figured out by doing my own internet research. My doc's attitude is somewhat like: just go ahead and take the meds and be done with it, because I think he thinks meds now are safe, and with a big vl, I might be running around infecting other people, so when i told him i had 3 sex partners last week, (all safe), he wasn't very happy.
4/24/07: Last tested Neg
1/22/08: First tested Poz
1/30/08: CD4 393; 28%; VL: 44k
3/18/08: CD4 218; 26%; VL: 222K
4/24/08: CD4 402; 26%; VL: lab forgot
7/22/08: CD4 405; 25%; VL: 6,780
10/15/08: CD4 340, 26%; VL: N/A
2/4/09: CD4 394, 26%; VL: N/A
Jun 09: CD4 300, 25%; VL: 4000
Oct 09: CD4 324, 23%, VL: 10K
11/22/09: started Atripla
11/20/11: CD4 405; VL: UD

 


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