Blood work:
A complete guide for monitoring HIV

May 2007     View PDF     En español

Lab tests, or blood work, can give important clues about your overall health and HIV disease. Many of these tests should be done shortly after learning that you’re HIV-positive. This will establish a “baseline” measure of your immune health and show how active HIV is. Knowing this information will help you watch for changes in your health over time as well as check the impact of any treatments that you take. Factors such as age, gender, stress, medicines, active infections and others can all affect these test results. Lab results should be considered with these factors in mind.

Understanding your test results may seem difficult at first. However, they can help you take charge of your health and understand why your doctor prescribes certain tests and medicines. With practice over time, it becomes easier to understand these results.

Nearly all lab reports make it simpler to understand test results by including a “normal” range, or high and low values. The results that fall outside normal ranges are likely the most important ones. Those that are above or below normal are often highlighted on your lab report by being bolded, printed in a different color or printed in a different column.

It is your right to have and keep copies of all of your medical records. You can then keep track of your results to look for overall trends. Ask for and keep copies of your lab reports, and make a chart or table of them to note trends or changes. For examples of these charts, read Project Inform’s publication, Personal Tracking Charts.

Although this publication may seem long and involved, it gives a thorough background to the types of tests that you may need to take over time. There are 5 key points to keep in mind when reading this material:

• “Normal” test values can differ. For example, lower cholesterol values may be considered normal in an HIV-positive person not on anti-HIV therapy. Be sure to discuss these differences with your doctor. Test results outside the lab’s “normal” range may not be cause for alarm.
• No single test result provides all the answers. Most results need to be considered along with other reports and within the context of your overall health.
• Different labs can get different results from the same blood sample because they use different methods or equipment. If for some reason you cannot use the same lab, you may need to establish a new baseline at the new lab. In the case of viral load tests, try to have the same type of test (bDNA, PCR, etc.) done each time. If your doctor sends you to the same place to give blood for testing, it’s likely the same labs and types of tests are being used. If you move or if you change doctors or health plans, it’s a good idea to check and see if your lab has changed as well. If you ever see dramatic changes in your lab results, you might ask your doctor if the lab or type of test have changed.
• Several things can impact your test results. For example, they can vary due to the time of day your blood is drawn. If possible, try to schedule blood draws at the same time of day every time. If you’re sick or have an infection, like a cold or flu, these can also affect your test results. You may want to wait to have lab work done or repeat the tests after you’ve become well again. Getting a flu shot or other vaccination can also alter lab results, as it stimulates the immune system and can increase how active HIV becomes. HIV levels usually return to “baseline” within a month after a vaccination.
• A dramatic change in results may be due to testing errors. As for CD4+ cell counts and HIV levels, it’s wise to have the test run again and to not make therapy decisions from any one test result.