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Author Topic: How much time should I wait before taking another test after started medication?  (Read 778 times)

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Offline patoduque

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I got tested positive around 3 weeks ago with HIV. Not only that, my CD4 was 180 so I had to start medication. Because of different circumstances, I was not able to start treatment until last week. Doctor said I should wait four months before getting a new CD4 and viral load... but that seems a lot to me! I am thinking about getting a test in two months... I am not expecting to see big improvements (if they are, great!) but I just want to ensure Atripla is working properly on me.

Do you think it's okay if I get tested two months after Atripla? Is it common to wait four months after I started treatment, even if my CD4 was 180 when diagnosed?

Thanks!

Offline tednlou2

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I've always heard that it is fairly standard to get labs drawn within 30 days in order to check viral load and toxicity to liver and kidneys.  CD4 is usually not checked within that 30 days.  Others here will know the recommendations, I'm sure. 



Offline mecch

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  • red pill? or blue pill?
It seems like a long wait to me....
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline emeraldize

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30 days

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
I agree - 30 days is the norm. At the very least you should be having a CBC and chem screen, including liver and kidney function tests at this point. Most doctors will also check the VL and CD4 too at 30 days. (If they're doing a CBC, adding in a CD4 shouldn't be a problem.)

Your doctor should also have run a resistance test first before starting you on meds. Do you know if this was done?

Personally, I'd be very wary of a doctor who didn't want me in for blood work four weeks after starting any hiv meds. Is he/she an hiv specialist or Infectious Disease doctor?

PS - you may find this lesson helpful: http://www.aidsmeds.com/articles/BloodTest_5030.shtml
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline patoduque

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Hi! Thanks a lot for your answers. It has been difficult since I live in a country in which medical services are not the best -if you read my post on how I knew I had the virus, you will realize I had to wait like two weeks for my confirmatory test and one week after prescription to get my medications. I have visited several specialists in infections - none of them is specifically for HIV, but they treat patients with this.

I actually asked them to get a resistance test to ensure the medication would work for me. The answer from the doctor was something like "this is working on all people here, what makes you think you are different?". So basically e explained that my body had to be very different for Atripla not working on me. Well, odds on getting HIV were low and I got it... Why can't I doubt about it? Still, to get that lab test I need a doctor'a order which I was not able to get.

With the doctor'a order on CD4 and Viral Load, I can go to any lab and get the test done (again - if I didn't have that, I would not be able to get it). Based on your feedback I will go and get it done 45 days after I started my medications and if I see something wrong I will call the doctor. Maybe he will be upset because I didn't wait the four months... But it's my life what we are talking about!

I feel really bad about the medical situation here. I have been thinking about maybe going to the US and have my control there - but if I do that, I would not be able to get Atripla here in my country and I don't think the insurance will cover me for the expenses I incur in the US.

As you can see this has been all a journey... Lucky me I can afford private doctors and the medicine by my own here in my country (Atripla costs 75 because of a special agreement!). I don't want to imagine how it is for people that has to go
To public hospitals.

Thanks again for your answers! :)

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Pat, are you going to be having other blood tests at the one-month point? If not, you should be.

Any good doctor will run a CBC, chem screen, including liver and kidney function tests at this point. These are heavy-duty drugs you're taking and your body functions - other than simply hiv markers such as VL and CD4 - also need to be checked to make sure you're ok.

If your doctor isn't going to run these tests (CBC etc) around the 30 day mark, maybe you need to find another doctor. 
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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  • red pill? or blue pill?
Patoduque - sounds like a good plan to take the initiative to get the best possible treatment where you live. 
Are there any AIDS/HIV associations where you can learn more about the ins and outs of HIV treatment in your country.  Maybe you should get a list of all the medicine that is possible available.  Anyway, chances are Atripla will be OK.  Just keep on top of things to make sure it is.
An American expression is - "the squeaky wheel gets the grease" which means many times in life a person has to be assertive to get what is necessary, cause society is trying to treat everyone the same, not doing ideally with resources, and generally being really bureaucratic about everything, etc. etc.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline patoduque

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@Ann yes! I am having my labs again in one month (maybe 45 days after I started medication). If I see that my levels changed versus my initial test, I will set up an appointment with my doctor. Another issue I have is that I only had a CD4 count and not a viral load... So it will be difficult to know how viral load is reacting to the medication! That's another reason I want to have my labs sooner - to have more reference points. I've been trying to find an HIV specialist where I live but it is difficult, that's why I am considering travel to the US to see an specialist. I don't want that the lack of attention from the doctor affects me in the end :).

@mecch I know! I was shocked when the doctor answered me that why I was thinking medication would not work in my body. I told him I was afraid and just wanted to ensure I had a great start - he insisted that having a resistance test would not lead anywhere. I don't feel different to others, I just want to have the right treatment for me. So I will have my labs early and try to monitor by myself and if I see something weird before the four months I will set an appointment with the doctor. Fortunately, economic resources are not a big limitation for me now... So I want to take advantage of that and ensure I get the best of the best.

Offline mecch

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  • red pill? or blue pill?
Try applying all your resources where you live. As you say, your atripla is 75 bucks.  I am not sure about this idea of going to the USA for tests, etc. All I know is care at developed world, retail prices, is ASTRONOMICALLY expensive and I don't know anyone in USA or Europe who is HIV+ and can pay the cost of treatment and medical care, out of pocket.  Even with pretty high salaries - we need some sort of insurance to do it. I think you would need to be really, quite rich to arrive in the US for HIV care and pay everything out of your wallet.
“From each, according to his ability; to each, according to his need” 1875 K Marx

 


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