Viral Blips & What?

 

The title of this piece says a lot...

"Viral blips during HIV therapy are common and rarely signal treatment failure, Swedish study finds"

This study followed a cohort of 4,000+ patients for 5 - 11+ years.  They found that on average a 1/5 of these patients would see at least 1 blip during that period.  A viral blip is defined as a patient with previously undetectable levels or suppressed HIV, suddenly being detectable, then being undetectable again after the next scheduled testing.  

The pathogenesis of blips isn't understood.  It could be a lot of things.  The most common finding was blips were more common among those having frequent, precise testing.   By this they mean being tested every 3 - 6 months & the test had a threshold of 50 copies per ml.  My blip came after the newer test lowered that number to 20.  IMO, the more precise & available testing becomes, the more common blips are going to be.  

As the title stated, blips are common & not necessarily a sign of treatment failure.   Read this piece.  It's a little lengthy, but informative.

Cya...

Irritating Conclusions...

 

There have been articles lately purporting anxiety & depression may be impacting HIV viral suppression.  I'm not posting links to these for 2 reasons; none of them were clear of what they were actually discussing & nor were they clear on causality or correlation.  

Meaning, none of these pieces were clear on what was causing what.  Is there a relationship between anxiety & suppression?  Is there non-adherence or is the mental state affecting the body to the point of suppression interference?

Another point, many doctors & researchers treat anxiety, stress & depression as merely mental issues.  Any of them can be mental health diagnoses.  However, sometimes life is & continues to be stressful, depressing & anxiety ridden.  Not all anxiety or depression is due to a mental disorder.  Many meds can induce anxiety or other factors like sleep interference or emotional reactions.

Until definitions are clear & direction of correlation or causality is shown, this research is at best a discussion point.  Putting abstracts out like these does no good.  It supports a hunch & may put further stress on patients trying to maintain suppression.  IMO, unless there is more not shown in these articles, these should not have been published at this time.  At this point, they came across as jargon supported conjecture.

Take care.

PS - we had 7" of rain in 24+ hours.  We passed our average & made up for October.

Cya...

Viral Loads & How Low...

 

I've already posted this article on Facebook, but it's important.  This piece is about viral loads & their measurement.  When I started regular testing, anything under 200 was considered undetectable.  However, most test now measure down to 20.  There are some that go to 10.  Anything under 200 is considered virally suppressed.  This piece questions if this newer, "better", more precise tests do any good.  Or if they only cause worry.  If you're consistently just over 20, you're detectable.  However, your HIV is still suppressed & unlikely to be transmitted to a partner.

There comes a point where precision isn't the aim.  Maintenance of suppression should be the primary goal.  How will doctors react to this?  Probably not well, they're prone to push.  This may become an issue for some people.  The goal is suppression, not perfection.  Until there's a cure even if you're undetectable, you're still HIV+.

Take care.

Cya...

Blips...

 

I had a blip on my last bloodwork.  My new specialist is the nervous kind.  He's reminds of a little dog trying to prove how big he is while checking off all his little boxes.  Anyway while I haven't had many, this isn't my 1st blip.   An undetectable viral load is under 20 copies per ml.  For some older tests that threshold is 50.  Mine was 28.   I'm still considered virally suppressed.  That's anything under 200, again those numbers were higher with older test.

This is a short piece over blips.  There are a lot online.  If you have a number slightly above undetectable wait until your next test.  It's likely to have gone back down.  As seldom as most people get test, 1 - 4 times annually, it's likely blips are more common than thought to be.  You're dealing with a virus & your body, nothing is static in this equation. Fluctuation is normal.  That's why testing is important.

That's it for now, take care.

Cya...

Low But Not None...

 

This is a well crafted piece, The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review." It comes from The Lancet & deals with with transmissions of HIV between serodiscordant partners.   Including the idea U=U.  

I've always had a problem with the undetectable equals untransmittable concept.  HIV levels can change quickly in certain circumstances.  The non + partner could be more prone to illness.   There are a lot of factors impacting U=U.  It's not that simple.  

The study found while transmission among those with low to undetectable viral levels were infrequent, they did happen rarely.  A major point they made was about definitions.  What is considered a low viral count, under 1000, under 200?  What does it mean to actually be undetectable?  

The long & short of it is, even though low viral counts or even undetectable means sex is safer, it doesn't mean it's absolutely safe.  Thus safer sex, not safe sex.  And this discussion has only been about HIV, not other STI's.

Be as safe as possible.  Use a condom, get tested, know your status, take care of yourself.  No one else is going to do this for you.

Cya...