A Look Editor. I am about to finish an important article dealing with this thing called "blip" viral. After searching in several dictionaries I started to look at my sources which could be a "viral blip". And with rare happiness, I found this article, whose sources are techne cited at end of article
Some people undergo transient viral load elevations which are called "viral blipes. The Viral Load rapidly returns to an undetectable level without any change in therapy. Several studies have found that 20 to 60% of patients with viral suppression with some experience of viral blipes (depending on the scheme used and the frequency of viral load tests), and perhaps a third of these repeated experiments. Most blipes are small, with viral load rising to somewhere between 50 and 1000 copies / ml.
Blipes can have several causes, including variability in the testing process, temporary changes in drug concentration, or transient discharges of immune activation, for example due to receiving a vaccine or having an infection such as influenza. A study measuring the viral load in blood samples from ten patients every three days to four months in two separate laboratories. Nine patients had one or more blipes of viral load but only one of the 18 blipes was detected by two laboratories at the same time.1
While a reduction in adhesion may cause increased viral load, most studies have shown that people who experience blipes experience no worse adherence than those with undetectable viral load consistently, nor is adherence necessarily lower before a blip .2 In addition, drug levels before, during and after the blip the viral load are often higher than the recommended minimum drug concentrations.3,1
Most doctors believe that an isolated viral load, a blip, is nothing to worry about. However, several blipes, or those that began to occur with increasing frequency, may be an early sign of imminent expiration on treatment failure.
Blipes are also not necessarily associated with the emergence of drug resistance.4 However, some studies suggest that transient increases in viral load may be a sign of sporadic activation of the immune system and may help replenish the latent viral reservoirs.5
The relationship between blipes and viral load and immune recovery is clear.3 6 Even with the best available therapy and optimal adhesion, viral blipes can occur. For this reason, it is advised to advise that the viral load should be checked at least twice to see if the increase is a continuous trend before deciding whether to change treatment.
- RE Nettles et al. Intermittent HIV-1 viremia (blips) and drug resistance in Patients receiving HAART. JAMA 293: 817-829, 2005
- LG Miller et al. Episodes of transient HIV viraemia (blips) are not associated with drops in medication adherence. Antivir Ther 8: S396, 2003
- V Martinez et al. HIV-1 intermittent viraemia in Patients treated by non-nucleoside reverse transcriptase inhibitor-based regimen. AIDS 19: 1065-1069, 2005
- PK Lee et al. HIV-viral load blips 1 are of limited clinical significance. J Antimicrob Chemother 57: 803-805, 2006
- LE Jones and Perelson AS Transient viremia, plasma viral load, and replenishment reservoir in HIV-infected Patients on antiretroviral therapy. J Acquir Immune Defic Syndr 45: 483-493, 2007
- PW Hunt et al. Continued CD4 cell count Increases in HIV-infected adults experiencing 4 years of viral suppression on antiretroviral therapy. AIDS 17: 1907-1915, 2003