Blood Chemistry (Chemistry or Chem Screens)
Blood chemistry tests, also called chemistry or chem screens, 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:
These tests help measure how well your liver is working. Some of the tests
measure liver enzymes such as alanine transaminase (ALT or SGPT), aspartate
transaminase (AST or SGOT), 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 include 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, a rise in bilirubin due to taking Reyataz is
These tests help measure how well your kidneys are working. They include
blood urea nitrogen (BUN), creatinine, and uric acid. Kidney tests are
especially important if you are taking Viread (tenofovir).
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 produced by the pancreas 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 our Diabetes info sheet.
Blood fat (lipids)
Many HIV+ people 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):
Cholesterol is a fatty substance that circulates in the blood. It is best to
keep your total cholesterol level below 200.
This is "bad" cholesterol, which can clog the arteries. It is best to keep your
LDL level below 100.
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 150.
HIV disease and HIV drugs can both cause
increased lipids (hyperlipidemia). Staying physically active, eating well, and certain medications can help lower high lipid levels. For
more information, see our info sheets on Hyperlipidemia and Lipodystrophy and Body Shape Changes.
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 our info sheet on Bone Health.
Labs routinely group certain chem screen tests together and call them
panels. Some common panels you may see listed on your lab report are:
- Basic metabolic panel: Includes calcium, electrolytes, kidney function, and
- 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 HIV+ people 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 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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