Hi doc My question is: I have been on azt,3tc,crixivan since 1995 when crixivan was in trial i never had change my combo or mised a dose? till today! Im also been on Remune for two years and did the (Z gene therapy)no plasebo.plus one siclo of il2. yes I did alot staff for my self. and I always been undetectable since 1995. under 500 first and with the new ultrasensitive tests under 20. for the las almost 7 yrs. my cd4 allways 700 to 1100, and my cd4 29 to 42. now 32 cd4 798. my question is I have my last lab test result showing my viral load 126?? its a blip i know! i should be worry about resisten? the test was the ultra sensitive under 20! its the first time a test show me hiv in my body!! hope you can healp! thanks.could be a wrong result? i was with a cold at that time? its normal? thanks very much for your healp. Rob.

Thank you for your question.

Very low viral load testing, particularly when preceded by undetectable viral loads are usually "blips". This is typically defined by a return to undetectability in the next several weeks.

We are many theoretical causes of blips, from misses doses of medications to low level immune activation-- as accompanies cold sores or vaccination.

We know from several studies (see Havlir, 2001; Sklar, 2001) that there does not appear to be any signficant risk of the emergence of resistance and/or drug failure from blips.

With viral loads less than 1000 copies, it is not reliably possible to get a viral genotype or susceptibility test to assay for resistance. Best advice is to just get the viral load run again after a few weeks (provided that you aren't sick or have missed doses). Good luck, BY