A study in the journal AIDS suggests that viral blips--transient detectable blood-based levels of HIV that suddenly appear in patients who otherwise had maintained undetectable viral loads--can be a warning sign of impending drug failure, particularly when blips are detected in two consecutive measurements. Investigators evaluated the characteristics and predictors of viral blips in 258 patients, 165 of whom maintained undetectable viral loads (except for the blips) throughout the yearlong study. They found that a single viral blip during regular viral load testing was not associated with a long-term risk of drug failure and viral rebound. Two consecutive blips, however, significantly increased the chances that the patient would experience viral rebound before the end of the study period.
"Given their high risk of short-term virological failure, patients who present with consecutive detectable [plasma viral load] measurements following complete suppression should be considered ideal candidates for intervention studies," the researchers concluded.