Taking tests which measure your health beyond your HIV viral load and CD4 count are important to stay in control of your health. Tests can help monitor what is going on in your body and the results can enable you to talk to your healthcare team about how you can look after your health. Your healthcare team will carry out some of the following tests to ensure you can enjoy lifelong good health.
Your bone health should be reviewed every year with a ‘bone profile’ blood test. This looks at nutrients in your blood, such as calcium. You may have extra screening depending on your age, gender and ethnicity.
At 40 your healthcare team will assess your risk of fracture with a questionnaire (sometimes called a FRAX® assessment).
At 50 you are at a higher risk of bone disease. Your healthcare team may scan your bones using a special X-ray called DEXA (DXA).
Osteoporosis, a bone disease, is more common in women after the menopause so your healthcare team may also scan your bones (using a special X-ray called DXA or DEXA).
People with dark skin are more likely to suffer from Vitamin D deficiency – also known as the ‘sunshine’ vitamin – which contributes to healthy bones. If you are black or Asian you may have a blood test to check the level of Vitamin D in your blood.
Your blood pressure and cholesterol should be monitored every 6-12 months. Blood pressure is checked with a device during the appointment and cholesterol is checked via a blood test.
Your risk of heart disease may be assessed with a questionnaire called the ‘Framingham score’ every 2 years.
Your kidneys should be checked every year using a urine dipstick to check for protein in your urine. If you are taking medications that may affect your kidneys, your healthcare team might ask you to do a test during every visit. You may also have a blood test every 3-12 months to monitor the level of a waste product called creatinine in your blood. These are routine tests in most clinics.
You should have a liver function assessment every year. If your healthcare team think you are at risk of developing liver disease they may perform liver function tests. ALT/AST, ALP, bilirubin are all terms used for tests your healthcare team may carry out between every 3-12 months – depending on what medication you are on.
Only those at an increased risk of lung disease will require routine screening.
If you are 35 or older, as a smoker or ex-smoker you may be screened for chronic obstructive pulmonary disease (COPD) - this may include a chest X-ray or a spirometry test (where you breathe into a machine) to measure how well your lungs are working.
If you experience breathlessness, a cough that won’t go away, a phlegm-y cough, wheezing or seem to always catch winter coughs (bronchitis), speak to your healthcare team. They may wish to refer you to a lung specialist (a pulmonologist) for further tests.
There are screenings available for many different cancers depending on your age, gender, lifestyle and current conditions.
All people living with HIV should have skin examinations, to spot any possible skin cancer.
Anyone over 50 should be screened for bowel cancer every two years.
All men aged over 50 should be screened for prostate cancer.
All women aged over 50 should be screened for breast cancer.
All women should be screened for cervical cancer. Screening is recommended every three years for women aged 25-49 and every five years for women aged 50-65.
If you are co-infected with Hepatitis B or C, or if you have liver cirrhosis, you may be screened for liver cancer. This can be performed via ultrasound.
Around 90% of anal cancer cases are caused by the sexually transmitted human papilloma virus (HPV). Some healthcare professionals may suggest anal exams or swabbing to screen for HPV and/or cancerous cells, but this is not routine.
Lung cancer is not routinely screened for, so quitting smoking is highly recommended.
While Hodgkin lymphoma, a type of blood cancer, is more common in people living with HIV (as it is linked to low CD4 count), it is currently unknown whether it can be screened for.
Your blood sugar levels should be checked every 6-12 months. If your blood sugar is consistently too high this could lead to a diagnosis of type 2 diabetes.
There are assessments available if you are concerned about your mental health. In the UK there is a screening check called HADS (hospital anxiety and depression scale) and there are similar ones in other countries. Your healthcare team should check your mental health at every appointment. If they don't mention it, you should ask. The earlier you are screened, the sooner you will get the care you need.