viral blips

Q: What does it mean by viral "blips"?


Answer: Viral "blips" is a phenomenon in HIV treatment where isolated incidents of low-level of detectable HIV RNA (50 to 200 copies/mL) occurs during the course of treatment despite full compliance from a patient. Reasons for these blips are not fully understood but they are either lab errors or release of virions not related to active viral replication. Mostly these blips are clinically insignificant, though there is some evidence that it may indicate an increased risk for virologic failure and predict future treatment failure. 

On a similar note, Patients with HIV who develop critical illness may have a transient increase in the viral load. Also, vaccinations can cause a transient increase in the viral load.

#infectiousdiseases


References:

1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf 

2. Nettles RE, Kieffer TL, Kwon P, et al. Intermittent HIV-1 viremia (Blips) and drug resistance in patients receiving HAART. JAMA 2005; 293:817. 

3. Gallant JE. Making sense of blips. J Infect Dis 2007; 196:1729. 

4. Laprise C, de Pokomandy A, Baril JG, et al. Virologic failure following persistent low-level viremia in a cohort of HIV-positive patients: results from 12 years of observation. Clin Infect Dis 2013; 57:1489.