VL blip

[TruthTakesTime]

I know this has been addressed on here, but I just wanted to have my own conversation about it, just for reassurance.

Had my most recent labs and check up a couple weeks ago and my VL came back at 26. I know this is obviously extremely low and under older standards would be considered "undetectable" and there could be many reasons for this "blip." It was just surprising to hear after being undetectable for the last several years. My doctor was unconcerned and had no complaints based on all my other results, CD4 was 890.

My anxiety just wants me to think this is the beginning of something bad even though that's not what all the evidence points to based on my google search and re-reading the older posts on here on the subject.

There's most likely no risk of transmitting at this level, right? Should I still consider myself for all intents and purposes as "undetectable"?

[Jim Allen]

Anything under 200 is considered UD in terms of forward transmission. https://forums.poz.com/index.php?topic=71848.0

I'm not surprised your doctor isn't concerned.

Minor blips can happen for various reasons, there is strong evidence that as ART takes care of the active viral load some transient blips are nothing more than the detection of the low-level release of virus from existing reservoirs, including defective copies and that those who blip more often tend to have larger HIV reservoirs and hence it's not a concern for with the treatment. See link for "What’s All This Fuss I Hear About Viral “Blips”?

Treatment wise, it's still generally accepted anything under 50 copies is fully suppressed/UD for best outcomes but I'm sure this micro blip you had will be gone the next time you test but if it keeps you awake at night and you need peace of mind you could always ask to do a VL test again in a few weeks. 

Take it easy.

Blips
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/

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


TaSP U=U
https://forums.poz.com/index.php?topic=71864.0
(*undetectable viral load defined as less than 200 copies/milliliter)

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

[TruthTakesTime]

Thanks for the reassurance and resources, Jim!