Treatment Timeline ~ Living with HIV in the Philippines

Treatment Timeline

Posted by Pozziepinoy on 8:38 AM

1st Consultation and Tests

Today you found out that you are HIV positive as shown in your confirmatory letter. You are shocked of course, because, who won’t be? The HIV status is pretty devastating as nobody around your circle has openly discussed about it. You get confused. You turn to read articles about it from the net. Then you realize that you need to do things for your health.

First you need to have a consultation with an infectious disease doctor (ID) specializing on HIV. There are good doctors in both private and government hospitals. However since the BESt doctors are in the HIV/AIDS Treatment Hubs in the country, then you might as well go there.

During the consultation, your doctor will get your history and will ask you to get all the lab tests required to know the status of your health. Part of the tests is the identification of the infections that you currently have. You will also be asked to get your CD4 count and your Viral Load tests to know the level of your immune system and the amount of HIV virus in your system. You can either do them while you are there in the treatment hub or in the hospital where you are having your consultation. If the CD4 and VL tests are not available there, you will be asked to get them in another hospital, just be sure to ask your ID doctor where it is.

There are three main treatment hubs in Manila. In RITM-ARG, you can get all the results in just one day as long as you come in early. Only the VL is delayed for 2-3 weeks depending on the number of patients getting it. In both PGH-SAGIP and San Lazaro Hospital, you can get the baseline lab test results during the day to two days after the testing while the CD4 and VL results, in a couple of weeks. The completed lab tests and CD4 result will determine as to when your second consultation will be. That is, if you get them all within the day, then you can get your second consultation also, within the day.

2nd Consultation

Once you finish your second consultation with your ID doctor, you will know if you need to take the antiretroviral therapy (ARV’s) or not. If your CD4 is still above 350, you will still not get the medicines and will be asked to have a healthy lifestyle instead and to return to the hub after 6 months to redo all the lab tests and CD4 test. If your CD4 however turns out to be 350 and lower, you will be asked to take the free trial ARV’s from the treatment hub after giving a briefing about the ARV’s. The trial period for this is 2 weeks to monitor for side effects for the ARV’s.

Taking The ARV’s

The monitoring period is 2 to 3 weeks. You will be following a strict routine of taking the ARV’s at the same time everyday, as ordered by your doctor. You are not allowed to miss or be late with your doses. You are also asked to monitor your diet, avoid taking supplements and herbal medicines to prevent reaction with the medicines.

During this period, you are asked to monitor for signs and symptoms of any side effects. such as a breakout of rashes, nausea, vomiting, dizziness, weakness, insomnia and wild dreams. You are to report any of these signs to your ID doctor as soon as possible. You might also be requested to come back to the treatment hub if the side effects are intolerable.

In case, there are no other side effects or the side effects are very minimal, your doctor will decide if you will continue with the same ARV regime. However, if the side effects are intolerable and becoming worse, then your doctor will decide on replacing your ARV combination. Your doctor may just replace one or two medicines depending on how your body is reacting to your ARV’s.

Third Consultation

When there are no side effects after 2 weeks, either from the start of your initial ARV therapy or after replacing your initial ARV therapy, you will be asked to come back to the treatment hub. Your doctor will give either give you a month supply or a three month supply of the ARV’s. You will still be asked to monitor any signs and symptoms of the side effects of the current ARV’s during the duration of the treatment.

Consultations as Needed

Unless you have side effects from your current ARV’s, or have infections that you think that your doctor needs to check on, you don’t need to come back to the treatment hub until you get your refill of your ARV’s.

ARV’s Refills

You will come back to your treatment hub after a week or two before you run out of your ARV’s. Usually there are no more consultations with your doctor, every 3 months as long as you don’t have side effects or any infections.

CD4 and Viral Load

Every six months you will be asked to get your CD4 to check if the ARV’s are working for you. It is then that some lab tests will also be done prior to your consultation with your doctor. The Viral Load is taken every year for comparison with your initial VL. The goal of the CD4 is to get your immune system to rebound with ARV’s and reach above 350. The ultimate goal of the VL is to reach undetectable level of HIV after a year of taking ARV’s