What laboratory tests are used to monitor HIV-infected people?
Monitoring the health of people infected with HIV (human immunodeficiency virus) involves a combination of laboratory tests and clinical assessments. Here are some commonly used laboratory tests for monitoring HIV-infected individuals:
1. Viral Load:
- Viral load testing measures the amount of HIV-1 RNA (genetic material of the virus) in a person's blood.
- High viral load indicates a higher level of HIV replication and increased risk of disease progression.
- Regular viral load monitoring helps evaluate the effectiveness of antiretroviral therapy (ART) and detect virologic failure.
2. CD4 Cell Count:
- CD4 cell count quantifies the number of helper T cells (CD4+ lymphocytes) in the blood.
- CD4 cells play a vital role in the immune system's ability to fight infections.
- Low CD4 counts indicate a weakened immune system and are associated with increased risk of opportunistic infections.
3. Complete Blood Count (CBC):
- CBC assesses various blood cell components, including red blood cell count, white blood cell count, and platelet count.
- Abnormalities in CBC might indicate anemia, infections, or bone marrow suppression due to HIV or ART medications.
4. Liver Function Tests:
- Liver function tests measure the levels of liver enzymes (e.g., alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase) and bilirubin.
- Elevations in liver enzymes might suggest liver damage or complications related to certain ART medications.
5. Renal Function Tests:
- Renal function tests evaluate the kidneys' function by measuring the levels of creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR).
- Changes in renal function may occur due to HIV-associated kidney disease or potential side effects of some ART medications.
6. Lipid Profile:
- Lipid profile assesses the levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides in the blood.
- Dyslipidemia (abnormal lipid levels) can occur in HIV-infected individuals and increase the risk of cardiovascular diseases.
7. Hepatitis B and C Serology:
- Tests for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) are performed to identify co-infections with hepatitis B virus (HBV) and hepatitis C virus (HCV).
- Co-infections can affect the management of HIV infection and require specific treatment strategies.
8. Drug Resistance Testing:
- Drug resistance testing evaluates the effectiveness of ART medications against different strains of HIV.
- It helps detect mutations associated with resistance to specific drugs, aiding in optimizing treatment regimens and preventing virologic failure.
9. HIV Genotyping:
- HIV genotyping identifies the subtype of HIV, which can provide information about the origin of the infection and may have implications for treatment decisions.
It's important to note that the specific laboratory tests ordered for monitoring HIV-infected individuals may vary depending on the individual's clinical status, disease progression, and treatment goals. Regular laboratory monitoring is crucial in the management of HIV infection to assess the effectiveness of therapy, prevent complications, and improve overall health outcomes.