Labwork : Chem-Screen - by Staff

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Hepatitis & HIV



by Staff

—EXPERTS CALL IT: “Metabolic Panel” or “Chem-Screen”
—IT TELLS YOU: If your major organs, muscles and bones are working the way they should
—TAKE IT: Every three months. More often if you have reasons to believe your vital organs aren’t doing well.
—SEE RESULTS IN: 2–3 days

M. Lo Talks: “I know there are liver toxicities to my HIV meds, but I haven’t seen them yet,” says Michelle. “I want it to stay that way.” A full liver workup gave her a clean bill of health, and the levels in her lipid panel were within the safety zone.

Chem-screens keep an eye on your organs (heart, liver, kidneys, pancreas), muscles and bones by measuring chemicals in your blood. They can alert your doctor to an infection or HIV-med side effects. Docs select from hundreds of individual tests depending on your HIV meds and your history.

A healthy liver keeps your blood free of toxic compounds and can help your body utilize HIV meds. A third of HIVers are coinfected with the liver-killing hepatitis C virus, so be sure to get tested for that, plus hep A and hep B. Also watch your labs for these:

A low level of albumin, the main protein in blood, suggests malnutrition, cirrhosis (scarring of the liver) or a side effect of hep B, hep C or an HIV med.

Alkaline phosphatase in higher numbers could signal an HIV med that needs adjusting, disease, injury, liver inflammation or strenuous muscle use.

A high level of bilirubin causes jaundice (yellowed skin and eyes) and could indicate hep A, B or C or viral infection. But some meds elevate bilirubin—and make you yellow—without, apparently, risk to your health.

Two blood-borne lipids can slow HIVers down. Unchecked, they can be deadly.

LDL cholesterol, the evil, low-density kind that clogs your arteries, puts you on track for heart disease. HIVers commonly test low for the good HDL, mostly from the virus itself but also from anabolic steroids or lack of exercise. Some HIV meds and HIV itself can boost the bad LDL; the jury is out on which combos to blame.

Triglycerides are the most common form of fat we eat. At high levels they’re associated with heart attacks and pancreatitis (inflammation of the pancreas). HIVers on protease inhibitors: Keep an eye on this.

The friendly, high-density HDL cholesterol actually scrubs your arteries clean.

Amylase and lipase are enzymes secreted by the pancreas that should also be monitored if you’re on the “d” drugs—d4T, ddI, ddC.

Blood urea nitrogen (BUN) spikes as a sign of dehydration, kidney or heart failure or liver or thyroid inactivity. Anti-inflammatory steroids, a high-protein diet and strenuous exercise could also be to blame. A BUN drop may reflect poor nutrition.

Creatinine tells how well your kidneys are filtering your blood. (Look out for false elevations from Bactrim or creatine.)

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