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Author Topic: Is morning time before noon the best to get a CD4 test?  (Read 1569 times)

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Offline gaynpositive

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  • Posts: 25
Is morning time before noon the best to get a CD4 test?
« on: May 07, 2013, 02:22:44 AM »
Hi members,

Is morning time (maximum by 12 noon) the best time to provide a blood sample for getting the CD4 test done? Or is it okay to provide sample at any time during the day?

My doctor/nurse says do provide a sample by 12 noon max, so that there is no issue of blood clumping or whatever (I couldn't understand much) and that it gets the most accurate CD4 result. However, I  got it done through a private lab and provided the blood in the evening at around 5.30 pm and the lab guy says that its okay to provide blood at any time during the day including evening time.

And when i got my report from the lab, it was printed in the report that CD4 increases during the course of the day. So doesn't this mean that by evening time, CD4s are the maximum in the blood and thats when we should provide the blood sample to get the most accurate result?

Please help me with this. I also want to get a VL done and these tests are very expensive here in India, so the least I want to get is an inaccurate result (or a result not correctly showing my numbers) just because I provided the sample at a wrong time of the day.

Love you all ! You guys have been my support system for months. And thanks in advance to all of you who can shed a light on this issue.

GnP

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Is morning time before noon the best to get a CD4 test?
« Reply #1 on: May 07, 2013, 07:00:43 AM »
"Sexually transmitted diseases: epidemiology, pathology, diagnosis, and treatment" By Kenneth A. Borchardt, Michael A. NobleTake
"CD4 counts show diurnal variation, being lowest in the morning and highest in the evening. In normal individuals the evening CD4 cell count can be nearly double what it is in the morning."

I couldn't find my link but I seem to remember that cd4s are lowest around 8:00-10:00 in the morning, and highest 8:00-10:00 at night. (It's a shame most clinics aren't open at 10:00pm :D ) Also cd4 counts can vary as much as 100 pts throughout one day. Getting your labs done around the same time of day every time is the better way to get the results of how your numbers are trending.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline gaynpositive

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Re: Is morning time before noon the best to get a CD4 test?
« Reply #2 on: May 07, 2013, 07:13:05 AM »
Thanks for the insight, Leatherman :)

However, I wonder if this is the case, why do the doctors still prefer to get it done in the morning hours? Like I said, my doc said to get it done by 12 noon..doesn't make any sense, is it? :)

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Is morning time before noon the best to get a CD4 test?
« Reply #3 on: May 07, 2013, 08:02:50 AM »
why do the doctors still prefer to get it done in the morning hours? Like I said, my doc said to get it done by 12 noon..doesn't make any sense, is it? :)
sounds like an issue with just your doctor and/or maybe the lab.

I've been having blood work done for 21 yrs in OH and in SC. Whether it was a draw in the doctor's office, the hospital lab, or the clinic, the times have been whenever I could get scheduled in.

Next time you see your doctor, why don't you ask if he has a reason for this? Maybe it's just for the convenience of the lab or the doctor... or maybe there's no reason and that's just the time he tells patients to impress on them to get it done.  ;) :D
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline bocker3

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  • You gotta enjoy life......
Re: Is morning time before noon the best to get a CD4 test?
« Reply #4 on: May 07, 2013, 09:39:59 PM »
And when i got my report from the lab, it was printed in the report that CD4 increases during the course of the day. So doesn't this mean that by evening time, CD4s are the maximum in the blood and thats when we should provide the blood sample to get the most accurate result?

Why would it be "most accurate" when it is at it's highest?  CD4s fluctuate during the day, so they are "accurate" anytime, so long as there isn't a sample handling or testing error. 

I worked in labs for many years and it really doesn't matter, in most instances, when a sample is drawn.  When tracking something that can change through the day, it makes sense to try to have it drawn around the same time, however. 

Morning is when most outpatients get drawn because, when fasting is needed, it is easiest to fast overnight and folks don't want to go all day without eating.  Minus a fasting need, there isn't much reason to draw in the morning over any other time (in most cases -- there are some tests, which escape me right now, where timing is important).

Bottomline, talk with your doc and find out what is driving his instructions.

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

Offline gaynpositive

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  • Posts: 25
Re: Is morning time before noon the best to get a CD4 test?
« Reply #5 on: May 08, 2013, 02:05:41 AM »
Thanks guys. I think yea, it might be just an issue with my doctor :) Will talk to him on this for sure.

Thanks again!

Cheers!
GnP

Offline bufguy

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  • Posts: 161
Re: Is morning time before noon the best to get a CD4 test?
« Reply #6 on: May 08, 2013, 04:57:11 PM »
My testing includes not only CD4 and Vl but lipids which require fasting which makes sense in the morning...I'm not going to fast all day or go for separate blood draws
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9

 


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