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Test Anxiety


Are you confused by all the data and abbreviations that appear on your lab report? Here is a breakdown of some of the most important results: ''Sodium, potassium, chloride, and carbon dioxide are called electrolytes, measuring your body's salts compared to the balance of water in your cells. They can be irregular if you are dehydrated or if you have kidney problems. ''Blood urea nitrogen and creatinine are measures of your kidneys' health. Elevated BUN can be a sign that you have wasting syndrome or simply that you have a high-protein diet. People taking creatine or protein supplements for workouts can throw off their creatinine levels. ''Albumin and protein relate to your nutrition; if they're off, they could be corrected by changing your diet. However, low albumin could be a sign of wasting. ''Bilirubin, alkaline phosphatase, AST, and ALT detail liver function. Elevated bilirubin could be a sign of bile duct blockage. But if you are taking either atazanavir or indinavir, the drugs can innocuously raise your bilirubin (and cause jaundice). AST and ALT (also known as SGOT and SGPT) are known as transaminases. If you are on antiretrovirals, it is OK to have up to three times the upper limit of these tests without worrying about liver damage. Anything higher than that and you might consider changing your meds. Transaminases are especially important to watch if you are coinfected with hepatitis B or C. ''Your lipid panel'consisting of total cholesterol, HDL and LDL cholesterol, and triglycerides'is a measure of fats in your blood. You need to fast for at least eight hours before blood is drawn for accurate test results. HDL is the 'good' cholesterol, so you want it to be high. LDL, the 'bad' cholesterol, should be lower. It is best to keep total cholesterol below 200; above 240 is cause for concern. Keep in mind, however, that if your total cholesterol goes up because your HDL has risen, this is actually a good thing. Lifestyle changes can improve cholesterol: eating better, exercising, quitting smoking. The 'statin' class of drugs, such as Lipitor, can lower LDL. Many people on anti-HIV meds have high triglycerides. ''Complete blood count, or CBC, enumerates red blood cells, white blood cells, and platelets. These numbers are almost always irregular for HIV patients. If you are on a medication or have a disease that damages your bone marrow, either can reduce red or white blood cells. ''RBC is your red blood cell count. If HGB (your level of hemoglobin, an oxygen-carrying component of red blood cells) is low, you can treat it with the drug Procrit. HCT, or hematocrit, is the percentage of your blood composed of red blood cells. If these three readings are low, you are anemic. The anti-HIV medication AZT is a common cause of anemia. ''Platelets help your blood to clot. HIV can lower platelet levels, but if you are on meds, you are probably protected. ''Hemoglobin A1C tests for diabetes by measuring your average blood sugar levels over the past 90 days. ''CD3+/CD4+ are your 'helper' T cells, which is what HIV attacks. Normal ranges are from 800 to 1,200 per microliter of blood, but you do not necessarily need that many to be relatively healthy. Current guidelines say to start taking anti-HIV meds below 350; if you have fewer than 200, you have AIDS and are at greater risk of infection. But if you are on combination therapy, you can get as low as 100 and still be relatively safe from opportunistic infections. ''CD3% is a very important'and often overlooked'measure of your T cells as a percentage of all white blood cells. If your T-cell count drops but your percentage remains stable'or even rises'this can reassure you that HIV is not killing too many of your T cells. Rather, your total white blood cell count has likely dipped, bringing your T-cell level down with it (thus keeping the percentage the same), which is not as much cause for concern. ''Viral load is the total number of HIV particles per milliliter of blood. It is important to understand that an undetectable virus does not mean that there is no virus at all; rather, the test is not sensitive enough to find any. These days, 'undetectable' means you have fewer than 25 copies, depending on which biotech company tests your blood, fewer than 75.

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