pushing out blood tests to 12 mths?

[friskyguy]

Hi all,

Currently testing my viral load and CD4s at 6 mth intervals......doctor Ok with this. Thinking about pushing out this to 12 mth intervals due to having to fly internationally to get this done, costs and related time contstraints. Fortunate that my numbers are stable and no issues.

What do you think?

[tednlou2]

I was just reading a study article about this, here on this site.  This article discusses every 6 months.  From reading other threads about this, I believe many here felt 12 months was too long?? 

Twice-Yearly Checkups May Be All That’s Needed to Control HIV

A recent study found that HIV-positive people with undetectable viral loads experience the same rates of virologic control whether they undergo checkups every three, four or six months. Challenging the current gold standard of quarterly doctor’s visits, the findings could ultimately help lower both the cost and hassle of HIV treatment for those who have stable HIV. April Buscher, MD, an attending physician at Durham VA Medical Center in North Carolina, announced the findings of her study at the IDWeek 2012 meeting in San Diego, first reported by MedPage Today. Conducting the study while she was a resident at Baylor College of Medicine in Houston, Buscher and her colleagues performed a retrospective cohort study that identified 1,512 men and 653 men, all of whom had undetectable viral loads at the beginning of the study. Dividing the cohort into subsets that saw their physicians at three, four or six-month intervals, the researchers found that in all three categories about 75 percent of patients maintained virologic control after one year. The data about those who waited six months between doctor visits may be limited, however, because that cohort was relatively small. The study also found that those who cancelled appointments were more likely to develop a detectable viral load.

http://www.poz.com/articles/761_23072.shtml

[wolfter]

Thanks Ted, I went searching for that article but you linked it first. 

I imagine some doctors might allow it, but I would never go that long.  I enjoy visiting my doctor every 4 months.  I guess I'd stress over not having my labs done more than yearly.

Wolfie

[newt]

I get my viral load 2 x year and CD4 1 x year, see the doc 1 x year, nurse the other time.

The problem with long gaps between tests is if for some reason your viral load creeps up, you don't catch it in good time, and the possible bad consequences of this eg resistance, loss of CD4s etc, perhaps then more complicated treatment and need for more frequent monitoring. The key thing here perhaps for you in deciding is your confidence in adhering to the meds, and being honest with yourself if this is going off a bit. CD4 is an expensive test and 1 x year for this in my book is ok if your count is good.

- matt

[intaglio]

Is there any way you can have your blood drawn where you live and send it off for testing? Then have the lab send the results to your doc? This might save you the cost of a flight each time. I'd look into this before I'd consider extending the time between labs.

[tednlou2]

That is what I was thinking.  Can you have bloodwork done where you're at?  I mean, it's not necessary to see your doc each time labs are done, especially once you know what the labs mean.

I am not sure how you pay for care.  I know many insurance companies charge you more for out of network providers.  I am not sure how that applies to having labs done internationally. 

[Pilot]

My doc wants me to see him every 3 months but I go every six months.  I have been undetectable for many years and the numbers stay pretty much the same. His reasoning is that he does not see me enough to notice any changes in my physical appearance that I might miss and could be a sign of something happening.  But most of the guidelines I have read says every six months is fine and some programs will only allow every six months unless something new is happening.  So do what makes you feel comfortable.

[emeraldize]

I get labs done quarterly, visits every six months and have initiated the chat about moving to one appointment per year (and sent the POZ article this week to my ID to back up prior chats about this).

[friskyguy]

thanks guys for your input.

cannot have bloods drawn here where i live due to risk of deportation upon being discovered with HIV. Same reason for sending blood supplies thru the post......dont think it can be done and would potentially draw much unwanted attention in any case.

Thanks newt for your suggestion. No problem to date with adherance and dont expect any problems with this going forward. However dont want to put myself in any danger just in case something goes wrong with the virus beyond my control.....so have decided to continue to fly roughly every 6 mths but yet can reduce medical costs by only testing for viral load as you recommended......as i am aware this is the most important variable due to my CD4 counts stable.

thanks again all