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July 2023 Advice to Be Well From Dr. Mark Bornstein and Dr. Paul Benson

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From Dr. Mark Bornstein and Dr. Paul Benson

Hi Doc, Whenever I look at my lab results on the portal, there always is a lot of “red” in the results and the provider never goes over them. Should I be concerned? Last time it said I have 1+ protein in my urine. What does that mean?

Hi AJ! This is a two-parter. Both are great questions and both have different answers. First, it is very important to understand that lab results are interpreted by your provider as a whole. When I see one lab that is “abnormal”, it matters what that lab is and what the other lab results during that blood draw were. Interpreting labs in isolation does not give the provider the entire picture. More importantly, on the patient side, it can lead to unnecessary anxiety. That being said, I never want to deter you from asking your provider questions. If you are curious about a lab result, please ask! I just want you to know that one lab result that is listed as abnormal does not always mean that there is a problem.

For your second part of the question, protein in the urine is something that the provider will be monitoring. There are many different labs that we use to monitor kidney function. Most of them are monitored in the blood but it is also important to monitor kidney function through your urine. Your provider will use the lab results from the blood and urine to develop a diagnosis and plan to address kidney results.

When someone has protein in the urine, it is a sign of kidney dysfunction and it needs to be addressed. There are many reasons for protein in the urine, although high blood pressure or diabetes are two common disease states that are often times the culprit. If you have either high blood pressure or diabetes, you should be monitored for protein in the urine. The reason this is important is that if it goes unaddressed for years, it can lead to further kidney damage.

Now for the positive and uplifting news… there are medications to help with protein in the urine! We have both older medications and newer medications that help preserve kidney dysfunction and decrease the amount of protein in the urine. This is why it is important to test. If we can identify dysfunction early and start someone on meds, we can prevent new kidney disease and further worsening of existing disease. As we always say, prevention is the best medicine.

I am living exceptionally well with HIV.

I am on a one pill once a day medication for treating HIV.  My viral load has aways been undetected and my CD4 count stable at around 600.  My doctor asked me if I was interested in entering a clinical trial with a new medication to treat HIV.  I told him I would think about it.  Is this a good idea? – MJ

 Dear MJ

Your decision whether to participate in a clinical trial is 100% voluntary.  It is your choice.  Scientific trials are regulated by the Food and Drug Administration (FDA).  Principle Investigators (Physicians or other qualified experts) are required to comply with Good Clinical Practice (GCP), GCP are laws and regulations to ensure integrity of data of which approvals of new medications are based, and most importantly protect the rights, safety, and welfare of human subjects.

Research subjects must read, sign, and understand the informed consent, which explains in detail what the clinical trial is about and the medication being studied.  There are 3 levels of clinical trials a compound must go through prior to approval.  Phase 1 has a relatively few healthy subjects and evaluates safety.  Phase 2 also has relatively few subjects and tests for efficiency.  The third phase has many participants and evaluates safety and efficacy.  Phase 3 trials usually are blinded (the investigator and the subject do not know if the study drug is the one being studied, a specified comparative drug used for the same proposed indication, or a placebo).   Phase 4 trials are sometimes used for post approval study of an approved drug.

As a clinical trial participant, you have the right to discontinue the clinical trial for any or no reason.  As a clinical trial participant, you should be certain you can comply with scheduled study visits and procedures for the entirety of the study. 

Clinical research is the engine that fuels new and better medications.  Many patients want to be part of that process and eagerly participate in clinical trials.  Others do not share that feeling.  Whether or not to participate in a clinical trial is your decision.  If interested, you should have a thorough discussion with the investigator and ask all the questions that you have during the informed consent process.  If it   does not feel right, don’t do it.  If it is something you feel good about, then go ahead and participate.

At the Be Well Medical Center we have participated in over 120 HIV related clinical trials since 1981.  We feel good knowing that we were part of the process in getting most of the medications we use to treat HIV today.  We are also currently participating in a HIV prevention study (PrEP) with an injectable medication injected every 6 months, as well as future medications for treatment naive and heavily treated patients living with HIV.  You can call our office and select option 7 to reach the clinical studies unit to hear about some of the studies we are currently participating in.

Thank you for the question!

Since 1980 Dr. Paul Benson’s Be Well Medical Center has been an inclusive medical center celebrating diversity. Do you have a health related question for Dr. Paul Benson and Dr. Mark Bornstein? Submit your questions to [email protected]. This article is a sponsored editorial produced in collaboration with Be Well Medical Center. Between The Lines’s journalism is made possible with the support and partnership of advertisers like Be Well. Learn more about Be Well here.

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