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Other tests
As well as monitoring your CD4 cell count and viral load, it's highly likely that you'll have other blood tests as well. Details of the some of the tests you can expect to have are provided below.
Blood counts
Doctors conduct blood counts to see if you are at risk of anaemia (a shortage of red blood cells).
Anaemia can be caused as a result of HIV disease itself. The nucleoside reverse transcriptase inhibitor (NRTI) AZT (zidovudine, Retrovir) and any combination pill that contains AZT (Combivir or Trizivir) can cause anaemia. The protease inhibitor indinavir (Crixivan ) has been linked to a small number of cases of anaemia.
Liver function tests
It’s very likely that you’ll have regular blood tests to monitor the function of your liver.
The non nucleoside analogue nevirapine (Viramune) can be toxic to the liver, as can protease inhibitors. Medicines used to treat other infections that people with HIV are vulnerable to can also cause liver problems.
Your doctor is likely to monitor your liver particularly closely if you are also infected with hepatitis B virus or hepatitis C virus (serious viruses which affect the liver).
Many people with HIV only discovered that they were infected with either (or both) hepatitis B or C because they had an abnormal liver function test result and were tested for the presence of these viruses.
Liver function tests look for levels of proteins in the blood, including serum albumin and bilirubin. Other liver function tests include asessing alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
Metabolic tests
Levels of cholesterol (fats) in the blood can be disturbed by anti-HIV drugs, particularly protease inhibitors. Triglycerides, blood sugars, and glucose can also be affected by HIV drugs. You are likely to have tests to monitor the level of your cholesterol, triglycerides and glucose just before you start anti-HIV drugs and then again every time you attend the clinic thereafter.
Liver function tests can give an indication if you have the rare but very serious side-effect lactic acidosis. This can be caused by some drugs in the NRTI class.
Blood samples may also be measured to check levels of the enzyme amylase. Abnormal levels of amylase can be a warning sign that you are at risk of the very serious side-effect pancreatitis. This can be caused by some NRTI drugs.
Kidney function test
Tests will also be conducted to see how well your kidneys are working, particularly if you are taking the protease inhibitor indinavir (Crixivan) or the nucleotide analogue tenofovir (Viread), as both these drugs are known to cause kidney problems.
Syphilis
If you are sexually active with more than one partner, your clinic may well test you regularly for syphilis. Recent outbreaks of syphilis in several cities in the UK, Europe, and American have been focused on HIV-positive gay men.