ojo. Hello there!… i’m glad that you decided for the medication. I am allergic to abacavir I remember that after taking it at night time I woke up, and I look like the pink panther. All pink, because of a bad rash, plus my skinny legs definitely I look like the pink panther… good luck
walkingpoz:
Hi guys little update and question about blips. Switched from Triumeq to Biktarvy 6 months ago and having no side effects. However for the 10 years I’ve been taking Triumeq I never had a detectable viral load (less than 20 copies) and now on Biktarvy my last week’s test showed a viral load of 30 which I hope is just an isolated blip. I read about what could cause a blip and learned that a cold or flu could cause one. I had a cold at the time of the test. Does anyone know anything about the mechanism of how a cold could cause an HIV viral load blip? I couldn’t really find anything about this online.
Jim Allen:
--- Quote ---Switched from Triumeq to Biktarvy 6 months ago and having no side effects. --- End quote ---
Excellent, glad to hear things are going well.
--- Quote ---now on Biktarvy my last week’s test showed a viral load of 30 which I hope is just an isolated blip. --- End quote ---
30 copies is not even a blip, it's fully suppressed and you just switched so it could be just this and the release of some defective copies from the viral reservoir. *1
Now, as for it being isolated, if they had monitored you every day I would put money on it that in the last 10 years you or anyone living with HIV would have had plenty of "micro blips" detected
--- Quote ---I read about what could cause a blip and learned that a cold or flu could cause one. I had a cold at the time of the test. Does anyone know anything about the mechanism of how a cold could cause an HIV viral load blip? I couldn’t really find anything about this online. --- End quote ---
Yeah, so the cold and blips, you will find it being mentioned but without references and just in passing.
Did you ask your healthcare provider this and if so, what did they say?
To my knowledge, (happy to be corrected) there are no studies specifically into HIV viral load and why co-infection with the common cold (rhinoviruses, coronaviruses, adenoviruses and enteroviruses) could cause an increase in VL. I suspect the mention of it is just clinical observations and there simply was no need or use for specific studies, or reports as the effects are not a clinical concern.
As for the mechanism, my limited understanding was that infections lead to immune activation, thus, increasing HIV replication and the viral load, but this isn't very relevant nowadays in the treat-all era and the current meds. The Swiss statement in 2008 initially had a caveat about certain co-infections that later got dropped as more was known.
Of course, there are plenty of studies both observational and some controlled trials regarding viral load mainly without ART and other more major co-infections such as TB, STIs, and Hepatitis, pre-2005 and the 90s but a lot has changed since then, I've included some references but take whatever they say with a large pinch of salt. *2
Anyhow, I'm not sure if any of the above helps but prehaps it points you in the direction or someone else will chime in with some specific knowledge + reference I missed.
1*
Prof. Fiona Lyons (HIV in 2024) https://forums.poz.com/index.php?topic=77637
Low-level VL linked to defective copies released from viral reservoir https://forums.poz.com/index.php?topic=77301
Reporting VL below 200 - “harmful medical practice” https://forums.poz.com/index.php?topic=77575
Viral Blips Don't Raise the Risk of HIV Treatment Failure https://www.poz.com/article/viral-blips-raise-risk-hiv-treatment-failure
Spanish study gives reassurance, small HIV blips do not predict treatment failure Teira R et al. Very low level viraemia and risk of virological failure in treated HIV-1-infected patients. HIV Medicine, online edition. DOI: 10.1111/hiv.12413, 2016.
What’s All This Fuss I Hear About Viral “Blips”? https://academic.oup.com/cid/article/70/12/2710/5573119
Q&A on persistent low-level viremia. https://www.healio.com/infectious-disease/hiv-aids/news/online/%7B8373ca63-674d-4015-ac35-f4da653c7415%7D/qa-understanding-persistent-low-level-viremia-in-people-with-hiv
2* Anderson RW, Ascher MS, Sheppard HW, Direct HIV cytopathicity cannot account for CD4 decline in AIDS in the presence of homeostasis: a worst-case dynamic analysis. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 17, 245-252.
Bentwich Z, Kalinkovich A, Weisman Z, Immune activation is a dominant factor in the pathogenesis of African AIDS. Immunol Today 1995, 16, 187-191.
Agegnehu, C.D., Techane, M.A., Mersha, A.T. et al. Associated Factors of Virological Failure Among People Living with HIV https://link.springer.com/article/10.1007/s10461-022-03610-y
Goletti D, Weissman D, Jackson RW, et al. Effect of Mycobacterium tuberculosis on HIV replication. Role of immune activation. J Immunol. 1996;157:1271–1278.
Schacker T, Zeh J, Hu H, Shaughnessy M, Corey L. Changes in plasma human immunodeficiency virus type 1 RNA associated with herpes simplex virus reactivation and suppression. J Infect Dis. 2002;186:1718–1725.
Kublin JG, Patnaik P, Jere CS, et al. Effect of Plasmodium falciparum malaria on concentration of HIV-1-RNA in the blood of adults in rural Malawi: a prospective cohort study. Lancet. 2005;365:233–240.
Kizza HM, Rodriguez B, Quinones-Mateu M, et al. Persistent replication of human immunodeficiency virus type 1 despite treatment of pulmonary tuberculosis in dually infected subjects. Clin Diagn Lab Immunol. 2005;12:1298–1304
Anzala AO, Simonsen JN, Kimani J, et al. Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. J Infect Dis. 2000;182:459–466.
Baeten JM, Strick LB, Lucchetti A, et al. Herpes simplex virus (HSV)-suppressive therapy decreases plasma and genital HIV-1 levels in HSV-2/HIV-1 coinfected women: a randomized, placebo-controlled, cross-over trial. J Infect Dis. 2008;198:1804–1808.
Celum C, Wald A, Lingappa JR, et al. Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2. N Engl J Med. 2010;362:427–439.