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Blip as precursor?
Oct 4, 2004

My VL has been undetectable for three years (Trizivir & Kaletra) and out of the blue I had a VL of 125. Retesting found it undetectable again. My doctor calls it a "blip" and says they see them from time to time. Do these blips portend viral escape? Non-nukes already won't work for me.

Response from Dr. Sherer

No. You have described quite well the circumstance in which a clinician can call a single viral load elevation a 'blip', i.e. a one-time value, followed by a return to a level below detection. Numerous studies have shown that such blips are not associated with a greater risk of virologic failure. These are quite common, occuring in 40% of patients in one series.

In contrast, numerous values in this range without a return to below the level of detection is associated with a higher risk of virologic failure, and is a reason for re-doubled efforts at optimal adherence and more intensive follow up with resistance testing.


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