HIV-positive adults routinely'usually every three months'have their blood screened for viral load measurements and CD4-cell counts as well as for the development of drug resistance. But blood tests also should check for other problems.
' Glucose levels. To screen for the development of insulin resistance or diabetes. Some anti-HIV medications have been linked with insulin resistance, which results in high blood sugar levels and potentially the development of diabetes, says Eric Daar, MD, chief of the division of HIV medicine at Harbor-University of California, Los Angeles, Medical Center. Insulin resistance and adult-onset diabetes, also known as Type II diabetes, are relatively common among overweight people and those with high blood pressure and high cholesterol levels. The chances of developing insulin resistance or diabetes increase with age regardless of other risk factors. Blood sugar levels can be lowered through dietary changes, oral medications, or'in extreme cases'insulin injections.
' Cholesterol and triglyceride levels. Some anti-HIV medications, particularly protease inhibitors'and possibly even HIV disease itself'can result in high blood lipid levels. Elevated bad-cholesterol levels, low good-cholesterol counts, and high triglyceride levels can boost the risk for heart attacks and strokes, says Daniel Klein, MD, chief of infectious disease medicine at Kaiser Hospital in Hayward, Calif. Cardiovascular risks also increase with age, regardless of whether a person is HIV-positive or not. Cholesterol and triglyceride levels can be lowered through dietary changes, exercise, and prescription medications.
' Kidney and liver function. Because HIV disease and some antiretrovirals can damage these vital organs, says Michael Allerton, HIV operations policy leader for Northern California's Kaiser Permanente Medical Care Program.
' A complete blood count. To screen for anemia, says Roxanne Cox-Iyamu, MD, medical director for the northern Virginia office of the Whitman-Walker Clinic.
Routine doctor visits also should include:
' body temperature measurement;
' blood pressure measurement; and
' screening for signs of depression and other mental health problems. 'We ask how the patient is doing, how they're eating and sleeping, if they're getting support, if they're getting up and out of the house each day, if their spirits are up, and other questions looking for general signs of depression,' says Daar.
