Dr. Antonio Urbina of St. Vincent’s Comprehensive HIV Center in New York City helps you understand your lab work
POZ: What do my CD4 count and viral load tell me?
Dr. Urbina: Your CD4 count is a good snapshot of how well your immune system is working and how much damage HIV has done. Viral load shows you how active HIV is in your body. It’s important to get a series of readings of both, instead of making decisions based on any single result. Results can bounce around, so it’s best to get several and see how they compare. CD4 counts below 200 are an immediate cause for concern because you’re much more at risk of opportunistic infections. Anti-HIV treatment is needed with counts that low, and advisable if you’re approaching them.
POZ: What other tests are important, especially for HIV-positive Latinos?
Dr. Urbina: Latinos on the whole are prone to diabetes and metabolic problems—trouble with your body chemistry. If you are HIV positive and Latino, your glucose (sugar) levels and your lipids (fats) are two key things to watch. The lipid panel measures the “good” or HDL cholesterol, the “bad” or LDL cholesterol and the “ugly”—another type of fat called triglycerides. If your glucose, triglyceride, “bad” cholesterol levels or your blood pressure are inching upward, that combined with your HIV puts you at risk for heart disease and other health problems.
POZ: What other health concerns should HIV-positive Latinos watch for?
Dr. Urbina: Diabetes is a condition in which your body isn’t able to process sugar (glucose) properly. The sugar is a fuel for your body, but if your body can’t control glucose levels, they can trigger a kind of domino effect. Excess sugar levels can affect your kidneys’ ability to hold on to protein. Losing protein, in turn, increases your risk of kidney disease and can cause your cholesterol levels to go up, which then creates a risk of heart disease. So high glucose levels can set off a cascade of other health risks.
POZ:What can you do to lower the risk for heart disease and diabetes?
Dr. Urbina: There’s a bit of genetic predisposition, but the main factor is probably diet. A diet that’s built around rice and tortillas contains a lot of sugar, which may need some adjusting if your lab work indicates a risk. The three best things you can do are: exercise, eat healthfully and keep your weight in a healthy range. Of course, those suggestions can also be the most difficult! It may be easier to take a pill to lower your cholesterol—and we will do that when it’s needed—but those “lifestyle” changes are really the best prevention. If your diet is an issue, it’s best if you can find a culturally trained nutritionist who can make the best recommendations for you.
POZ: How can you make sure your lab work is picking up these risks?
Dr. Urbina: High blood pressure and metabolic problems are more likely to go undiagnosed and undertreated in Latinos and other people of color. You should be getting your weight and blood pressure checked at each visit, and sugar and cholesterol measured twice a year. If any levels are abnormal, that signals a need for more intensive monitoring.