Blood chemistry tests measure certain chemicals in your blood. Results of these tests give your health care provider important information about your general health status, how well organs like the liver and kidneys are working, and whether you may be experiencing drug side effects. Abnormal results can indicate a problem that needs to be addressed. Important blood chemistry tests include:
- Liver function
These tests help measure how well your liver is working. Some of the tests measure liver enzymes such as alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP). High levels of liver enzymes may be a sign of liver damage. Several HIV drugs can cause elevated liver enzymes. Liver function tests also measure bilirubin, which comes from the breakdown of hemoglobin from RBCs. High levels of bilirubin may indicate liver problems. Taking the HIV drug Reyataz (atazanavir) can increase bilirubin levels; however, this rise in bilirubin is harmless.
- Kidney function
These tests help measure how well your kidneys are working. They include blood urea nitrogen (BUN), creatinine, and eGFR, which is a measure of how well your kidney is filtering different chemicals in the blood. Kidney tests are especially important if you are taking Viread (tenofovir) or any of the combination drugs that contain tenofovir. For more information on any of these HIV drugs, see our HIV Drug Chart article.
Electrolytes play important roles in the healthy functioning of cells, nerves, and organs. Bicarbonate (CO2), chloride, potassium, and sodium are electrolytes. Electrolyte imbalances may be caused by not getting enough nutrients (malnutrition) or water (dehydration), or by kidney problems.
- Blood sugar (glucose)
Your body uses glucose for energy. High glucose levels (hyperglycemia) can be a sign of diabetes or insulin resistance (when the body does not respond to insulin, a hormone to help control glucose levels). High glucose levels can be a side effect of HIV drugs. Your health care provider can monitor your levels through glucose tests. For the most accurate results, it is best to check glucose levels when you have been fasting (not eating or drinking anything but water for about eight hours). For more information, see The Well Project's article on Diabetes.
- Blood fat (lipids)
Many people living with HIV have an increased amount of fat, or lipids, in their blood such as cholesterol and triglycerides. Higher cholesterol levels can increase the risk of a heart attack or stroke. Higher triglycerides can increase the risk of damage to the pancreas (pancreatitis). Your lab report will list the amount of the following lipids in your blood (for the most accurate results, it is best to check lipid levels when you have been fasting):
- Total cholesterol
Cholesterol is a fatty substance that circulates in the blood. It is best to keep your total cholesterol level below 200.
- Low-density lipoproteins (LDL)
This is "bad" cholesterol, which can clog the arteries. It is best to keep your LDL level below 100 to 130.
- High-density lipoproteins (HDL)
This is "good" cholesterol, which helps reduce the risk of heart disease. It is best to get your HDL level up to at least 40.
After eating, energy that is not needed right away is converted into a substance called triglycerides, which is stored in fat cells. It is best to keep your triglyceride level below 100 to 150.
HIV infection and HIV drugs can both cause increased lipids (hyperlipidemia). Staying physically active, eating well, and certain medications can help to lower high lipid levels. For more information, see The Well Project's articles on Hyperlipidemia and Lipodystrophy and Body Changes.
- Blood proteins
These tests provide information on nutrition problems and help diagnose kidney disease, liver disease, and many other conditions. Tests include albumin and total protein.
Calcium, one of the most important minerals in your body, is a major part of bones and teeth. Blood calcium is tested to check for a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. It is important to remember that you can still have weak bones (osteoporosis), even if your calcium blood test is normal. For more information, see The Well Project's article on Bone Health.
Labs routinely group certain chemistry tests together and call them panels or profiles. Some common panels or profiles you may see listed on your lab report are:
- Basic metabolic panel: Includes calcium, electrolytes, kidney function, and glucose
- Comprehensive metabolic panel: Includes same tests as basic panel plus blood proteins and liver function
- Lipid panel: Includes cholesterol, LDL, HDL, and triglycerides
The Bottom Line
Since many people living with HIV have no noticeable symptoms of health problems, it is important to get regular lab tests to monitor how you are doing. Abnormal blood tests can be a sign of serious health problems and need to be addressed as soon as possible so that you can remain healthy and strong.
Whether you are taking HIV drugs or not, all the tests listed above are a key part of your medical care. Regular monitoring is an important way to take charge of your health.
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