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Viral load >20 but <50 (blip?)

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Acesra:
Hi community members,

I have been on the treatment for the last 3 years, and my viral load had always been undetectable below 20. But recently, over the last 6 months, with two separate lab tests, the vial load is said detectable. One time was 30, and recently 42.

I'm worried why it's not under 20 like before, and it says detectable. I wonder if it's because I was covid-19 vaccinated. My doctor told me not to be worried because it's still under 50.

But I'm getting very paranoid. I'm scared.

Does anyone have knowledge or more understanding about this? I googled but no clear information available.

Thank you,

Jim Allen:
Hiya,

So recently vaccinated, I'm presuming you have taken your meds as prescribed and no other changes or illness?

I agree with your doctor, as less than 50 copies isn't even a blip and is fully suppressed.  Now, minor blips over 50 copies can happen for various reasons, had some myself over the years. Unless it were into the mid to high hundreds, I would not even blink.

Another reason not to worry about such low levels is evidence that as ART takes care of the active viral load, some transient blips are nothing more than detecting the low-level release of virus from existing reservoirs. This includes defective copies and that those who blip more often tend to have larger HIV reservoirs and hence it's not a concern for the treatment etc.

See link for "What's All This Fuss I Hear About Viral "Blips"?

Treatment wise, it's still generally accepted that anything under 50 copies is fully suppressed, 200 for onward transmission (UD), so keep taking your meds correctly and see the result next time you test.

Blips
What's All This Fuss I Hear About Viral "Blips"?
https://academic.oup.com/cid/article/70/12/2710/5573119

http://i-base.info/guides/changing/viral-load-blips

Viral Blips Don't Raise the Risk of HIV Treatment Failure
https://www.poz.com/article/viral-blips-raise-risk-hiv-treatment-failure

http://www.aidsmap.com/Spanish-study-gives-reassurance-small-HIV-blips-do-not-predict-treatment-failure/page/3085173/

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

Jim Allen:
How are you feeling/doing otherwise?

leatherman:
anything under 200 is considered successfully treated HIV, so there's nothing to worry about.

here's something from another thread:

--- Quote from: leatherman on June 29, 2021, 04:12:23 pm ---"undetectable" is such an imprecise word. Until there is a cure, there's always some HIV in your system, either free-floating or stored in reservoirs where it stays latent for the most part. Periodically, this latent HIV will reactivate - and that's why we take meds every day to stop this HIV. Theoretically then you could test one day and have results for "undetected" (which only means that the test which goes to 20, didn't detect at least 20); but the next day you could test and get a "detected" result .... if those latent reservoirs released some HIV. "<20 detected" means that the test, which goes down to 20, measured some HIV but <20. Is that any different really than "<20 undetected"? not really. In both cases the viral load is well under 200 (which is the goal of successful treatment) and if the patient remains adherent to meds, there's nothing to worry about.

--- End quote ---

Acesra:
Thank you @Jim and @leatherman for your replies. This information is so helpful.

Since diagnosis, I have become so paranoid with everything. Everything feels like a dead letter. I must say, although more than 3 years have gone by and I'm taking medication religiously without a miss and I'm healthy, I am still scared and afraid of everything. I still have not recovered from the trauma of the diagnosis.

Thanks especially @Jim for always being there supportive, informative, responsive, and constructive. You remain a pillar of stability throughout these evolving roller-coaster journeys.

Again, I really appreciate that you spent time to type your responses.

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