Viral load >20 but <50 (blip?)

[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:

"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.

[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.

[Bucklandbury]

Acesra, I do not know you and perhaps should not speak as I have only been diagnosed six months myself, but in looking back at your original VL and CD4 count, you were pretty good relative to many others at diagnosis, myself included.

I am trying not to worry about things going forward. I know it is hard, but the reality is, you can only take your meds, see your doctors routinely, and mitigate current bad health habits - if you have any (too much drink, using illicit drugs, smoking, lack of exercise, eating shite food).

I am the pot calling the kettle black. I have done nothing but worry since my AIDS diagnosis. It is hard not to, so I get it!

Worrying will not change anything and may make things worse. Be thankful you had not progressed to AIDS, and take comfort in the fact that as long as you take your meds, you will not do so.

Your post is helpful. I will one day get a blip, and I will remember this post - I have saved it - and will not freak out then, so thank you for asking your question.

[Acesra]

Thank you Bucklandbury for your reply. Your advice about being worry-less is appreciated.

[Jim Allen]

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.

  You're welcome.

I hope with time the feeling of being scared passes.  I know with the pandemic there has been little opportunity for us to talk to others face to face, but do you have any face to face support? Have ever met or considered meeting peers living with HIV?

[Jim Allen]

P.S I Apologise for not replying sooner. Things have been a tad hectic.

Jim

[CR2016]

Hi Acesra.
i have had about 3 blips since 6 years of diagnosis. first time, i was very worried too. It was about 100-150 my cv, remember; after that this got down and a couple of test after went up again to 80 aprox. then go down again, and so.
Main idea to you, don worry about this. Pay attention for taking your meds and care for health. There are so many things we cannot to control and i know it is hard to hand it some times.
be happy, enjoy your body, love it.
sorry my english
hugs!

[Acesra]

@Jim, thank you for your reply. Apologies for my late response too, I was not checking this site for some weeks. I used to attend a monthly support group group meeting prior to the pandemic. Now the monthly meeting is virtual, and is open to everyone from everywhere. I'm paranoid and worried that it's a virtual meeting, people can secretly screenshot or record the meeting. So I have not attended since the group meets virtually. I should perhaps look for another group that meets in-person.

@CR2016, thank you for sharing your experience. It's good for me to hear similar experiences.

The latest test showed that the viral load has gone down below 20. It was such a relief.