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Higher HIV Blood Level Isn't Always Bad News

Brief Increases Known as 'Blips' Don't Mean Drug Resistance, Study Finds
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Feb. 16, 2005 -- Temporary increases in HIV blood levels, called blips, are nothing to worry about.

The "blips" experienced by HIV patients undergoing HIV treatment are random and don't signal drug resistance, according to a study in the latest Journal of the American Medical Association.

HIV treatment consists of a combination of several drugs. The medicines don't get rid of HIV. Instead, they slow down the rate at which HIV makes copies of itself, suppressing the virus.

"Blips" sound innocent, but they can rattle a patient's confidence. They occur when the virus briefly pops back up to detectable levels despite treatment. Understandably, blips can be nerve-wracking for patients until retesting shows that the blip is over.

Many patients experience blips, according to researcher Robert Siliciano, MD, PhD. Besides prompting patients' fears and expensive tests, blips can also trigger broader worries that the virus is becoming resistant to HIV treatment. Siliciano works with Johns Hopkins University's medical school.

Newer HIV treatment combinations have made a huge difference -- helping people live longer, healthier lives. A study in The Lancet's October 2003 edition showed that nine out of 10 HIV-infected people on HIV treatment can expect to survive more than 10 years, regardless of their age.

Checking for Drug Resistance

Siliciano's team took a hard look at blips. First and foremost, they wanted to find out if drug resistance was at work.

Their study was small, with 10 patients aged 39 to 59 years. Seven participants were men; three were women. All the patients had undetectable levels of HIV in their blood at the start of the study and had been on stable HIV treatment for at least six months.

Participants' blood was scrutinized far more than normal. For three to four months, they gave blood for the study every two to three days. The intense schedule was designed to flag any rise in HIV blood levels.

During the study, nine of the 10 patients had a blip. On average, patients experienced two blips during the study. Most blips were brief, lasting an average of 2.5 days. Only one person had a blip lasting for more than one consecutive visit.

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