ABOUT THIS ACTIVITY (CONT.) There are also a number of other tests that your doctor will
probably order as a baseline measurement—to be able to keep
Materials: track if things change. As time goes on, these other tests will be
ordered periodically, or if your doctor suspects a problem.
• Laptop
• Projector with screen or blank white We’ll discuss each of these tests in more detail in a moment.
wall
• Markers
Slide 5-6: Periodic Labs
• Participant booklet to follow lesson
and power point A fter the baseline lab tests have been taken, your doctor will ask
you to take them again periodically. Now what does that mean?
To begin, generally every quarter, or about every 3 months
Preparation: None
throughout your treatment, your doctor may want to perform
the lab tests listed here:
• Viral load test
• CBC
• CD4 T-cell count and percentage
• A lipid profile for cholesterol and triglycerides
• A fasting blood sugar test for diabetes
Your doctor may also want you to take these additional tests:
• Liver function tests, because many HIV/AIDS meds are
processed by the liver
• Kidney function test, because many HIV/AIDS meds are
excreted by the kidneys
• Hepatitis A, B, and C
• HIV resistance (if your therapy fails to lower the viral load or
achieves only suboptimal suppression)
• Toxoplasma antibody IgG (which tests for a blood-borne illness
that people can get from cats)
• CMV IgG
Beyond blood tests, these additional screenings may be done:
• Pap smear, including a vaginal pap smear for women, and an anal
pap smear for men and women
• Full sexually transmitted disease or STD screening
• Chest X-ray
• PPD skin test for tuberculosis
Slides Lipids 17 - 19 • A
bnormal ranges put one at risk for cardiovascular
events and pancreatitis Many HIV medications affect
• HIV, and some HIV meds, can increase lipid levels cholesterol
• People with high levels of LDL cholesterol and
triglycerides are at a greater risk for:
Cardiovascular (heart) disease Slide 20: Blood sugar levels
Heart attack G
lucose is sugar and is broken down in your body to
Stroke provide your cells with energy. High blood sugar may
• Factors that can increase the risk of elevated lipids be a sign of diabetes, which can lead to a variety of
include: cardiovascular and other health problems. High blood
Family history of cardiovascular disease sugar levels eventually cause damage to your eyes,
High blood pressure nerves, kidneys, and heart. Some HIV medications,
Smoking including protease inhibitors, can increase blood sugar
• Things you can do to decrease the risk include: levels.
Eat healthy
Exercise
Quit smoking
Appropriate lipid-lowering drugs
Summary
• Cholesterol - Types of fat in the blood • U nderstanding your labs enables you to play an active
Triglycerides - <150 (related to amount of sugar and proactive role in your health care
intake) • Use your new knowledge of lab tests and lab values to
Cholesterol - <200 be a partner with your doctor
LDL (lethal) – bad cholesterol <100 • Live smarter, healthier, and happier by being in control
HDL (healthy) – good cholesterol >60
* This module is part of the online toolkit Building Blocks to Peer Success. For more
information, visit http://www.hdwg.org/peer_center/training_toolkit.
This module comes from the Missouri People to People Training Manual, 2008.
Building Blocks to Peer Success 5
UNDERSTANDING LAB VALUES
SESSION HANDOUT # 1 of 1
Making
Making Sense
Sense of
of Lab
Lab Values
Values
•• Doctors
DoctorsUse
UseLab
LabTests
Teststo
toMonitor
MonitorYour
YourHealth
Health
•• Lab
Labtests:
tests:
–– Detect
Detectthe
thepresence
presenceof
ofdisease-causing
disease-causingorganisms
organisms
Making
Making Sense
Sense of
of Lab
Lab Values
Values •• (e.g.
(e.g.bacteria,
bacteria,viruses,
viruses,parasites)
parasites)that
thatmay
maybe
berelated
relatedtotoHIV
HIV
–– Tell
Tellwhen
whento totreat,
treat,how
howtototreat,
treat,and
andififtreatment
treatmentisis
Understanding working
UnderstandingLabs
Labsand
and working
–– Identify
Identify the development of side effectsrelated
the development of side effects relatedto
to
Why They Are Important
Why They Are Important treatment
treatment
–– Detect
Detect other infections and problems associatedwith
other infections and problems associated withHIV
HIV
infection
infection
Step
Step 2:
2: lab
lab timeline
timeline
Step
Step 1:
1: lab
lab basics
basics Your
YourTreatment
TreatmentTimeline
Timeline
Confirm
Confirmyour
yourpersonal
personalinformation:
information: Tests
Testsyou
youmay
maytake
takeatatbaseline
baseline
–Name
–Name
–Age
–Age Baseline
Baselinetests
tests Other
Othertests
tests(not
(notusing
usingblood):
blood):
Complete blood count (CBC) STD screening
–Gender
–Gender Complete blood count (CBC)
CD4 T-cell count and %
STD screening
Pap smear (women/men)
CD4 T-cell count and % Pap smear (women/men)
–Social
–Socialsecurity
securitynumber
number
Drug resistance testing
Drug resistance testing
Chest X-ray
Chest X-ray
HIV viral load test Tuberculosis test
HIV viral load test Tuberculosis test
Ask
Askabout
aboutanything
anythingyou
youdo
donot
notunderstand
understand Chemistry panel
Chemistry panel
Liver function tests
Liver function tests
Kidney function tests
Kidney function tests
Hepatitis A, B, and C
Hepatitis A, B, and C
Toxoplasma IgG
Toxoplasma IgG
Cytomegalovirus
Cytomegalovirus
Periodic
Periodic labs
labs DEFINITIONS
DEFINITIONS
Periodic
Periodiclabs
labs
•• Viral
Viralload
loadtest
testshows
showsthetheamount
amountof ofHIV
HIVRNARNAin inyour
your
Viral load test
Viral load test blood
bloodand andtells
tellsyou
youhow
howactive
activethethevirus
virusisisin
inyour
your
CBC (complete blood count)
CBC (complete blood count)
CD4 T-cell count and %
body.
body. Higher
Highernumbers
numbersmean meanyou youhave
have more
more virus
virus in
in
CD4 T-cell count and %
Lipid profile and blood sugar (fasting)
Lipid profile and blood sugar (fasting)
your
yourbody.
body.
•• Opportunistic
Opportunisticinfections
infectionsare
are illnesses
illnessescaused
causedby by
Occasional
Occasionaltests/vaccines
tests/vaccines different
differentorganisms,
organisms, somesomeofofwhich
whichdodonot
notusually
usually
Liver function tests
Liver function tests
Kidney function te sts
cause
cause disease
disease ininpeople
people with
withaanormal
normalimmune
immune
Kidney function te sts
Hepatitis A, B, and C
Hepatitis A, B, and C
system.
system. Opportunistic
Opportunisticinfections
infectionsof ofthe
thelungs,
lungs,brain,
brain,
HIV resistance
HIV resistance eyes,
eyes,andandother
otherorgans
organscan
candevelop
developin inpeople
people with
with
Toxoplasma IgG test
Toxoplasma IgG test
Cytomegalovirus
Cytomegalovirus
HIV
HIVinfection.
infection.
Labs
Labs (3-4
(3-4 months)
months) Lab
Lab values
values
•• CBC
CBCvalues •• Viral
values
–– Red
Viralload
load
Redblood
bloodcell
cellcount
count
•• Cells
Cellsthat
thatcarry
carryoxygen
oxygen
•• Chemistry
Chemistrypanel
panel
–– White
Whiteblood
bloodcell
cellcount –– Liver
count Liverfunction
function
•• (different
(differenttypes)
types)make
makeup upthe
the
immune –– Kidney
Kidneyfunction
function
immunesystem-fight
system-fightinfection
infection
•• CD4
CD4 –– Lipid
Lipidprofile
profile
–– One
Oneofofthe
thewhite
whiteblood
bloodcells
cells •• Fasting
Fasting––11yearly
yearly
(Lymphocyte)
(Lymphocyte)that thattell
tellother
otherwhite
white •• Blood
blood
bloodcells
cellstotoattack
attackHIV
HIV Bloodsugar
sugar
•• Drug
Drugresistance
resistancetesting
testing One
Oneofofthe
themost
mostcommonly
commonlyused
usedblood
bloodtests
tests
Genotype(done
–– Genotype (doneasasneeded)
needed)
Examines
•• HIV
HIVinfection
infectionwithin
within22years
yearsofof Examinesblood
bloodcomponents
componentsincluding
includingred
redand
and
diagnosis
diagnosis–resistance
–resistanceprofile
profile white
whiteblood
bloodcells
cells
Blood
Bloodcomponents
componentsare
aremade
madeininbone
bonemarrow,
marrow,
which
whichcan
canbe
be
affected
affectedby
byHIV/AIDS
HIV/AIDSand
andantiretroviral
antiretroviralagents
agents
Lymphocyte
Lymphocyte tests
tests What
What about
about ups
ups and
and downs?
downs?
•• CD4
CD4isisaaWBC
WBCcalled
calledLymphocyte
Lymphocyte •• CD4
CD4T-cell
T-cellcounts
countscan
canvary
varyaccording
accordingto:
to:
–– Counts
Countsthe
thenumber
numberofofCD4
CD4T-cells
T-cells –– Type
Typeofoftest
test
–– Time
Timeofofday
day
•• Normal
NormalCD4
CD4count
count(helper
(helperT-cell
T-cellcount)
count) –– Current
Currentororrecent
recent
–– 600-1500
600-1500cells/mm
3
cells/mm 3isisnormal
normalfor
forhealthy
healthyadults
adults infection
infection
–– Children’s
Children’scounts
countsare
aremuch
muchhigher
higher –– Stress
Stress
•• Less
Lessthan
than200
200cause
causeincreased
increasedrisk
riskof
ofopportunistic
opportunisticinfections.
infections. Lower
Lowerthe
the
CD4 –– Fatigue
Fatigue
CD4drops,
drops,the
themore
morerisk
risk
•• CD4%
CD4%
–– More
Moreconsistency
consistencythan
thanaasingle
singlemeasurement
measurement
–– Less
Lessthan
than30%
30%means
meanssome
somelevel
levelofofimmunodeficiency
immunodeficiency(weakened
(weakened
immune system)
immune system)
CD4
CD4 (%)
(%) Percentage
Percentage Viral
Viral load
load
•• CD4
CD4accounts
accountsfor
for30%-60%
30%-60%ofofall
allthe
theimmune
immunecells
cells •• One
Oneof
ofthe
the most
most important
importanttests
testsyou
youwill
willtake
take
•• Usually
Usuallydoes
doesnot
notvary
varyas
asmuch
muchasasthetheactual
actualCD4
CD4 about
aboutevery
every33months
months
measurement
measurement
•• Some
Someproviders
providersmight
mightconsider
considerstarting
startingantiretroviral
antiretroviraltherapy
therapy •• Often
Oftenconsidered
consideredthe
thecritical
criticalmarker
markerin
inthe
the
when
whenthe
theCD4%
CD4%isis<15-17
<15-17even
evenififCD4
CD4remains
remains>>350
350copies
copies management
management ofofHIV
HIVand
andAIDS
AIDS
•• Measures
Measuresthe
the amount
amountof
ofHIV
HIVin
inyour
yourblood
blood
Viral
Viral load
load Chemistry
Chemistry panel
panel
Liver
Liver function
function tests
tests Kidney
Kidney function
function test
test
•• HIV
HIVcan
cancause
causekidney
kidneydamage
damage
•• Most
MostHIV
HIVmedications
medicationsare
areprocessed
processed –– So
Socan
candiabetes
diabetesand
andcardiovascular
cardiovasculardisease
through
throughthe
theliver
liver disease
•• Conditions •• Many
ManyHIVHIVmeds
medsare
arecleared
clearedfrom
fromthe
thebody
bodyby
bythe
the
Conditionsthat
thataffect
affectyour
yourliver
livercan
can
also
alsoaffect
affectyour
yourmeds
meds kidneys
kidneys
•• Tests
Testsused
usedtotomonitor
monitorliver
liver •• InInpeople
peoplewith
withreduced
reducedkidney
kidneyfunction,
function,the
thedoses
dosesof
of
function
functionare:
are: some
someHIV
HIVmeds
medsmay
mayneed
needto tobe
beadjusted
adjusted
–– ALT,
ALT,also
alsoknown
knownas
asSGPT •• Tests
–– AST,
SGPT Testsfor
forkidney
kidneyfunction
functioninclude:
include:
AST,also
alsoknown
knownas
asSGOT
SGOT –– Blood
–– Bilirubin BloodUrea
UreaNitrogen
Nitrogen(BUN)
(BUN)
Bilirubin –– Creatinine
–– Alkaline Creatinine
Alkalinephosphatase
phosphatase
Lipid
Lipid panel
panel Lipid
Lipid tests
tests
•• HIV,
HIV,and
andsome
someHIV
HIVmeds,
meds,can canincrease
increaselipid
lipidlevels
levels
•• People
Peoplewith
withhigh
highlevels
levelsofofLDL
LDLcholesterol
cholesteroland
andtriglycerides
triglycerides
are at a greater risk for:
are at a greater risk for:
–– Cardiovascular
Cardiovascular(heart)
(heart)disease
disease
–– Heart
Heartattack
attack
–– Stroke
Stroke
•• Factors
Factorsthat
thatcan
canincrease
increasethe
therisk
riskof
ofelevated
elevatedlipids
lipidsinclude:
include:
–– Family
Familyhistory
historyofofcardiovascular
cardiovasculardisease
disease
–– High
Highblood
bloodpressure
pressure
–– Smoking
Smoking
•• Things
Thingsyou
youcan
cando
doto
todecrease
decreasethe
the
risk
riskinclude:
include:
–– Eat
Eathealthy
healthy
–– Exercise
Exercise
–– Quit
Quitsmoking
smoking
–– Appropriate
Appropriatelipid-lowering
lipid-loweringdrugs
drugs
Lipids
Lipids Blood
Blood sugar
sugar levels
levels
•• Cholesterol
Cholesterol--Types
Typesof
offat
fatininthe
theblood
blood
–– Triglycerides
Triglycerides--<150
<150(related
(relatedto
toamount
amountofofsugar
sugarintake)
intake)
–– Cholesterol
Cholesterol--<200
<200
•• LDL
LDL(lethal)
(lethal)––bad
badcholesterol
cholesterol<100
<100
•• HDL
HDL(healthy)
(healthy)––good
goodcholesterol
cholesterol>60
>60
–– Abnormal
Abnormalranges
rangesput
putone
oneatatrisk
riskfor
forcardiovascular
cardiovascularevents
eventsand
and
pancreatitis
pancreatitis Many
ManyHIV
HIVmedications
medicationseffect
effectcholesterol
cholesterol
In
In closing
closing
•• Understanding
Understandingyouryourlabs
labsenables
enablesyou
youto
toplay
playan
anactive
activeand
and •• Activity
Activity
proactive
proactiverole
roleininyour
yourhealth
healthcare
care
“Test
“Test Tubes”
Tubes”
•• Use
Useyour
yournew
newknowledge
knowledgeofoflab
labtests
testsand
andlab
labvalues
valuesto
tobe
beaa
partner
partnerwith
withyour
yourdoctor
doctor
•• Live
Livesmarter,
smarter,healthier
healthierand
andhappier
happierby
bybeing
beinginincontrol
control