Any recommendation inexpensive HIV doctor in Bangkok?

[david_je]

A female Thai friend who is HIV-positive and has been taking ART for almost a year is looking for a knowledgeable HIV specialist because her current doc does not seem competent. She cannot afford the Bumrungrad docs mentioned in this forum. Can anyone with experience pls recommend  a specialist at a government (preferred) or inexpensive private hospital? Also, her blood test a week ago at Anon Clinic showed her CD4 count drop to 140, from 185 six months earlier (though CD4% rose from 8 to 9, and viral load remains undetectable). So she is worried. Thanks for your advice.

[Sheryl]

Unless things have changed, she should be able to see a doctor at the Anon Clinic. However she is going to need to sort out her situation under the govt system for the long term. What hospital is she registeted at and is it under SS or 30 baht scheme? And on what basis has she determined her current doctor is "not competent"? In govt hospita HIV clinics they have very clear proticols to follow so highly unlikely she is receiving substandard care. Might it just be a problem of communication? Thai doctors are often poor at ecplaining things and the time constraints of government clinics adds to this, patients often get no chance to ask questions.

In some patients there is a significant time lag between achievement of viral suppression and rise in CD4. The VL is the most current measure of HIV infection while the CD4 can reflect past rather than current viral loads.

Also, CD4 counts normally flunctuate quite a bit, from day to day and even hour to hour depending on a host of factors. CD4% is usually a more reliable indicator than absolute CD4 count. If the CD4% has not dropped then there has not been a real decrease. That said, there has also not been a real increase as 9% is still low.

Some people are much slower than others to increase CD4 after achieving viral suppression. The reasons for this are poorly understood. But as long as VL remains suppressed, CD4 will eventually rise.

The important thing is that she still needs to receive medications to prevent opportunistic infections until her CD4% reaches around 15%. These would be drugs like cotrimaxazole and INH.

If she is still receiving these along with the HAART then I think she just needs reassurance and some face time with a doctor able to spend time answering questions/explaining. Unfortunately this is not easily obtained through public channel at a government hospital and even through after hour clinics (which nowadays in Bkk cost about 500 baht) time is limited.

If she is unable to see a doctor at the Anon Clinic try the Silom Comminity Clinic at Bangkok Christian Hospital. Free or minimal cost.

Alternatively, Chulalongkorn Hospital after hours clinic. Ask for an acharn with specialization in Infectious Disease. Consultation will be about 500 baht.

2.





Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[Blue bruce]

Have you tried the Red Cross clinic that specializes in HIV???