Tests During Treatment Process and Their Meanings

A number of tests will be required from you while your doctor plans your treatment steps. This section explains these tests and why they are performed. Remember that different tests might be required during your HIV follow-ups as per your personal health condition. In this section, tests required during a routine check are explained. Your doctor might require tests not listed here, and this is not unusual.

CD4 Cell Count: CD4 cells count which HIV decreased by infecting. It’s performed every 3 months in the beginning of the treatment, then every 6 months or once a year. Higher number of cells means that immune system is stronger accordingly. Usually these tests also include CD4/CD8 ratio follow-up with CD8 count.

Viral Load (HIV RNA): Scans the virus amount in the blood. In the beginning of the treatment, it gives information on the infection status, and the treatment progress after the treatment. While it varies as per performed laboratory method, values over 40 copies in 1ml of blood can be measured. Treatment’s initial goal is to reduce the amount of virus in 1ml of blood to 50 copies and stabilize. This test is required every 3 months or 6 months following the treatment.

Resistance Test: Measures the resistance of the virus in your body against the medications you’re using. Used in designation of the optimum treatment for first-time medication users.

HIV’s structure mutates due to various reasons while reproducing in the body. And this might result in different HIV type occurrences. These mutations might occur during medication use, too. Such cases cause the virus to gain resistance against the used medications and counteract the treatment.

Resistance test can also be performed if the viral load reduced to a detectable level with the treatment increases again, in order to switch to another medication.

It’s not a commonly performed test in Turkey, except in three centers. Due to test’s process logic, you might get the results a few months later, or the first sample might show no result. In such cases, jumping to negative conclusions about the virus status, or panicking is unnecessary. Since the test results can take long, your doctor might decide to start the treatment without waiting for the resistance test results. When immediate medication use is required, medication treatment starts with experimental methods.

If virus suppression begins and is maintained, it means that no resistance has been detected. If virus suppression doesn’t begin, your doctor might opt for another medication.

Tuberculosis Test (PPD)

In Turkey, tuberculosis is one of the major opportunistic infections that occur in people living with HIV. Therefore, performing the PPD skin test, which detects if the person encountered the tuberculosis bacteria, can be crucial.

Based on your PPD test results, your doctor might request the quantiferon blood test. All results are validated along with chest X-ray and sputum culture results.

Bone Densitometry

HIV and some medications are known to affect bone health. Some people living with HIV might experience reduced bone density and fracture risk before starting the treatment or during the treatment. Your doctor might decide to measure your bone mineral density with Bone Densitometry and follow-up.

Hemogram (Complete Blood Count)

Complete blood count is performed to detect the status of some cells in your blood. Red blood cells (erythrocytes) are the cells carrying oxygen to body tissues. Low RBC count along with low hemoglobin (Hg) and Hematocrit (Hct) indicates to anemia. It may cause fatigue and tiredness.

Thrombocytes (Plt) are active in blood coagulation process. If you have low thrombocyte levels, your blood won’t coagulate quickly. You might have gum bleeding and the small cuts may not stop bleeding instantly. A lower level might cause more serious bleedings.

Leucocytes (white blood cells), with their various types, function in body’s fight against germs, and are also active in immune system. High leucocyte levels might indicate to an infection. And low leucocyte levels might increase your chance of getting infections.

You might see the below parameter levels on your hemogram test results. We can only explain their meanings to you. Only a doctor can validate your test results. Trying to validate your test results online will lead to inaccurate results.

RBC: Erythrocyte amount in red blood cells. These are oxygen carrying cells.

HGB: Hemoglobin. Shows the hemoglobin amount in blood. These are red blood cells mixed with the oxygen in blood.

HCT: Hematocrit. Shows the hemoglobin and erythrocyte amount in blood.

PLT: Platelets count, also called thrombocyte count. It shows the cells enabling coagulation. Thrombocyte amount is scanned for iron-deficiency anemia and acute infections.

MPV: Shows the average size of of thrombocytes in blood.

PDW: Shows the distribution width of thrombocytes in blood.

MCV: Average size of the red blood cells carrying oxygen. An important finding in complete blood count.

MCH: Shows the total hemoglobin amount in red blood cells (erythrocytes).

MCHC: Concentration of erythrocyte and hemoglobin in percent.

RDW: Shows the distribution of erythrocytes.

WBC: White blood cell count. It shows the number of white blood cells (leucocytes). They are part of defense and immune system of the body.

CRP: C-reactive Protein. Normally found in low levels in human body.

PNL: Neutrophils. They increase when bacterial infections incline.

NE%: Percentage of neutrophils. Main function of this cell is to detect the harmful foreign substances in the body and destroy them.

LY%: Percentage of lymphocytes. These cells are part of the immune response. They decrease in viral infections and some chronic diseases.

MO%: Percentage of monocytes. These cells are capable of phagocytosis and play an important role in immune system regulation directly or indirectly through lymphocytes.

EO: Percentage of eosinophils. Shows the percentage of the cells responsible for destruction of the foreign substances. It’s scanned for allergic and parasitic diseases.

BA%: Percentage of basophils. Basophils are also capable of phagocytosis but they display their main function by releasing various substances.

Biochemistry Tests

These tests showing the operating level of your body functions and organs are performed to detect the changes and waste in your body, and to measure the levels of some necessary elements. Liver and kidney function tests are repeated on a certain basis as a precaution if required, in order to detect the side effects of HIV in the body, and the side effects of medication in the sequel.

You might see the below parameter levels on your biochemistry test results. We can only explain their meanings to you. Only a doctor can validate your test results. Trying to validate your test results online will lead to inaccurate results.

Calcium / CA: Required for validation of endocrine and metabolical disorders.

Phosphor: Required for validation of phosphor metabolism’s acid-base balance and calcium-phosphor balance.

Urea: One of the kidney function tests.

Glucose: Shows the blood sugar levels, and is measured for diabetes diagnosis on an empty stomach for 12-24 hours.

Total Protein: Required for the follow-up of kidney and liver diseases.

Hemoglobin: Required for validation of anemia, blood loss and so on.

Uric Acid: Required for diagnosis and follow-up of gout and other purine metabolism disorders. Uric acid increases in cases such as gout, kidney deficiency, leukemia and heavy exercise.

BİL-D: Required for validation of liver and gallbladder functions.

BİL-T: Required for validation of liver and gallbladder functions.

SGOT-AST-SGPT-ALT-GGT: These abbreviated test names mean liver function scans. Doctor requires these tests when there’s a suspicion of liver damage.

ALT: Alanine Aminotransferase. One of the liver function tests.

AST: Aspartate Aminotransferase. An intracellular enzyme found in all body tissues, but in larger amounts in liver, heart and skeletal muscle.

GGT: An important enzyme in liver diseases, especially alcohol-related liver diseases.

ALP: Alkaline Phosphatase. Required for validation of liver, gallbladder and bone tissue related diseases.

LDH: Lactate Dehydrogenase. Required for diagnosis of heart and liver diseases.

HDL: Shows the fat level in blood, known as good cholesterol.

LDL: Required for validation of coronary heart disease risk. Shows the fat level in blood, known as bad cholesterol.

Total Cholesterol: Shows the total cholesterol level.

VLDL Cholesterol: Required for validation of lipid metabolism.

Creatine Kinase: Required for validation of conditions causing degeneration of skeletal muscle and heart muscle.

Amylase: One of the function tests for pancreas, salivary glands and some tumor secretions. While alcohol use increases the amylase level, pancreas deficiency decreases it.

Triglyceride: Natural fats derived from fatty acids or glycerol. More dangerous than cholesterol.

Iron: Required for validation of all anemia, iron deficiency and iron poisoning cases. Iron level decreases in conditions such as iron-deficiency anemia.

Sodium: Required for validation of electrolyte and water balance.

Potassium: Required for validation of electrolyte and acid-base balance, also for follow-up of kidney functions.

Chlorure: Required for validation of electrolyte balance, acid-base and metabolic water.

Magnesium: Required for validation of Mg metabolism and electrolyte balance, also for follow-up of patients under hypertension treatment during pregnancy.

Creatinine: Gives information on kidney function. Required for validation of kidney functions.

Fasting Blood Sugar Level: Required for validation of carbohydrate metabolism.

Postbrandial Blood Sugar Level: Usually scanned two hours after the meal.

Albumin: A protein synthesis that is synthesized in liver, which gives information on blood’s oncotic pressure.

Iron Binding Capacity: Required for validation of serum iron levels.

Syphilis Tests

VDRL – RPR: First stage scan test performed when screening a possible syphilis condition.

TPHA: A newer and more specific test than the other methods in detection of the antibodies for Treponema pallidum bacteria, which is a syphilis factor.

Hormone Tests:

T3: Required for validation of total T3 thyroid functions.

T4: Required for validation of total T4 thyroid functions.

FT3: Required for validation of free T3 thyroid functions.

FT4: Required for validation of free T4 thyroid functions.

TSH: Thyroid Stimulating Hormone. Required for validation and treatment follow-up of thyroid functions.

B12: Scans the B12 vitamin level.

Folik Asit: Folat eksikliğinin tanı ve tedavisi takibi ile çeşitli anemilerin değerlendirilmesinde kullanılır.

Folic Acid: Required for validation of diagnosis and treatment follow-up of folate deficiency, and some anemia types.

AFP: A tumor scanner for specific tumors.

CEA: Used as an indicator of colon, rectal, lung, breast, liver, pancreas, prostate, stomach and ovary cancers. Smokers have high CEA levels. Therefore, using it as a scan test is wrong.

ELISA

HBsAg: Required for diagnosis of acute or chronic Hepatitis B infections. Presence of HBsAG more than 6 months indicates to chronic carriage or chronic liver disease.

HBeAG: Required for follow-up of Hepatitis B Virus. It occurs after HBsAg at early stages of the infection. It proves the active viral replication of the virus.

Anti-HBe: Required for follow-up of Hepatitis B Virus. It occurs after HBeAG disappears.

Anti-HBs: Required for detection of immunity against Hepatitis B Virus infection. When Hepatitis B Virus disappears (after HBsAG disappears), Anti-HBs occur. It’s also used for detection of resistance after the Hepatitis B Virus vaccination.

Anti-HAV IgM: Required for diagnosis of acute Hepatitis A virus infection. It appears in the blood when symptoms start, and usually remain positive for 3-6 months.

Anti-HAV Total: Required for validation of immunity against Hepatitis A.

Anti-HCV: Required for diagnosis of Hepatitis C Virus infection. It usually exists in the blood during the late stage of Hepatitis C Virus infection. Presence of Anti-HCV does not ensure immunity. Positive results must be confirmed with other methods.

CMV IgG: Cytomegalovirus is a virus in the family Herpesviridae and known as CMV. This test is used to determine whether someone had CMV infection before.

CMV IgM: This test is used to determine whether someone has an active CMV infection.

Rubella IgG: This test is used to determine whether someone had Rubella infection or got vaccinated against Rubella before.

Rubella IgM: This test is used to determine whether someone has an active Rubella infection.

Toxoplasmosis IgG: Toxoplasmosis infection occurs when Toxoplasmosis Gondii parasite enters the body.And this test is used to determine whether someone had this infection before.

Toxoplasmosis IgM: This test is used to determine whether someone has an active Toxoplasmosis infection.

Urine Tests

Density: It measures the urine density.

pH: pH is a value showing the acidity or alkalinity of a liquid. This test measures the acidity of urine.

Leucocytes: Indication of white blood cells in urine. They might have occurred due to infection.

Nitrite: Nitrite in urine is an indication of bacterias producing nitrite.

Protein: Usually detected in pregnant women. Detection in normal patients indicates to kidney disease. Also, the protein type disposed of in urine is important for diagnosis.

Glucose: Should be negative. But if blood glucose level increases, it might show in urine as well.

Keton: Genellikle aç kişilerde ortaya çıkar. Hasta ne kadar aç ise keton o kadar yüksektir. Ayrıca diyabetli hastalarda da rastlanır.

Ketone: Usually detected in hungry people. The hungrier the patient is, the higher ketone levels are.Detected in diabetes patients as well.

Bilirubin: Normally not found in urine, and occurs in cases such as jaundice.

Erythrocyte: Checks whether there’s blood in urine.

IMPORTANT NOTE: This section explains what these required tests scan in your body. It does not give any information about the optimum test results. Your test results must absolutely be validated by your doctor. Everyone’s results will differ based on their health background. Only your doctor can decide if low levels or high levels in your test results mean something. Do not panic when you see low and high levels in your test results. Sometimes high levels or low levels in small amounts can be insignificant. You should consult your doctor for validation of your test results. Online validation may cause jumping to wrong conclusions.