Q and A

Question

Is a viral load result of 50 really a blip?

I have been on Atripla for over 2 years now, with an undetectable viral load for over 18 months.

My CD4 count was 145 when I started and is now 700 which I’m told is excellent.

However, my latest viral load result came back detectable at 50 copies/mL. The doctor assured me it’s just a blip and the extra test I did today will be back to undetectable. What’s your thoughts on this? I really don’t want to change from the one pill at night.

Answer

Most probably your doctor is right. A ‘blip’ is when someone’s viral load is generally undetectable, but on an odd occasion comes back as over 50 copies/mL. The upper limit is often taken to be 100-200, but single blips can even go to 2000 and still drop down again without changing treatment.

Blips are fairly common and unfortunately nobody can explain them, so far. Most people who have one or two blips continue on the same therapy for many years with an undetectable viral load again with their next test result. Your current result is barely detectable, so could easily also be a lab error.

Taking immediately a second sample for a viral load test was the best course of action, so in that respect you have received the care that is currently recommended in UK (BHIVA) treatment guidelines.

You are right that you have otherwise had an excellent response to treatment.

Hope this helps.

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