Viral Blip. Mental spiral.

[Allthefeelings]

I've experienced a viral blip for the second time in four months; it was 32 in April, and now it's 104. I've been extremely diligent with my medication, but I can't help obsessing over my lab results. I'm aiming to switch from Biktarvy to either Dovato or Cabenuva, but it feels like a distant goal. When I was diagnosed in April 2022, my initial viral load was 80,000 and my CD4 count was just 22. Since then, my CD4 count has only slowly climbed above 200, and now with two consecutive blips, I'm feeling hopeless. I regret that I only reach out here when things are tough, but I don't really have anyone else to talk to about this.

[Tonny2]

           ojo.             Hello there!… no need to feel bad for not being here that often, as a matter fact, I tell everybody as soon as they know that they’re treatment is working to go back to their normal lives… well, two blips, they don’t look too bad to me, but, what did your doctor say about it?. Do you know your CD4%?… try to relax because if indeed you treatment is not working, you will have more options of treatment.… Good luck, and please keep us posted and try to relax, fortunately, now a days it’s not the end of the world… Hugs

[harleymc]

It took over 6 years to get over 200 t4 cells.


Try and book in to see a counsellor recommended by your HIV health care service and or start booking longer dr's appointments do you can talk these issues through.

Good luck

[daveR]

I can relate to how you feel. After years of being undetectable I had three six monthly checks all with increasing numbers. Ranged from 22 to just over 200. Then two months ago back to undetectable. The Dr at the time showed no concern what so ever. She initially blamed the laboratory on the first one and just shrugged at the next two results.

Try to relax and stop thinking about the numbers, you are on good medication, I am sure yours will do the same as mine did and drop back down. Occupy your mind some how, when not working I read. Meditate daily. Possibly find a hobby that helps you relax.

Dave

[Jim Allen]

I've experienced a viral blip for the second time in four months; it was 32 in April, and now it's 104. I've been extremely diligent with my medication, but I can't help obsessing over my lab results. I'm aiming to switch from Biktarvy to either Dovato or Cabenuva, but it feels like a distant goal. When I was diagnosed in April 2022, my initial viral load was 80,000 and my CD4 count was just 22. Since then, my CD4 count has only slowly climbed above 200, and now with two consecutive blips, I'm feeling hopeless.

Hiya,

Firstly, I'm sorry to hear that you feel stressed by this, what did your healthcare provider say? Are you still taking any supplements? If so prehaps keep off them for 30 days before your next VL test and see what happens.

now I think something you and a lot of us might want to take on board is that nobody here has a VL of zero. Despite what some lab reports or doctors might say, the VL is always there just sometimes below the lab threshold to detect in the small specimen taken but HIV treatment is not about being "undetectable" for the labs tests.

You started treatment in April 2022, VL has been 97,000, 203, 60, 22 and 104. You have a suppressed viral load and your treatment is working great, I would be pleased with these results if they were mine, as the goal is met, job done!

Personally, only if I had continuous VL results over 200 I would consider it an important indicator. However, low-level stuff or the odd spike is mostly insignificant.

The reason being detectable in lab results, can happen for all kinds of reasons, not to mention the threshold of labs keeps getting lower and lower without much point from a clinical sense, anyhow, detected viral load can also include defective copies being released from the HIV reservoir that are incorrectly counted.  I suspect microblips are more common in the first few years of treatment but that is just my anecdotal observation.


Sorry, this reply has gotten so long, anyhow, could switching HIV treatment help you beat the lab tests? Prehaps,  something to discuss with your healthcare provider. Would going from a consistent VL between 22 - 200 to below 20 copies make any difference to your life or health? No *

*
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

"What’s All This Fuss I Hear About Viral “Blips”?

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

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