What’s the Impact of Low Level Viremia — Another Part of HIV

Ending AIDs by 2030 is an integral part of the SDGs (Sustainable Development Goals), adopted by UN Member States in 2015^[1]. Nations are demonstrating strong commitment and concerted efforts to combat HIV/AIDS and achieve epidemic control. However, various factors can influence the effectiveness of these endeavors, including the impact of low level viremia.

Viral load response provides an idea of the amount of the HIV virus in the body. It is presented as the number of viral particles (HIV RNA copies) per milliliter of blood. Below are the main viral load response levels in HIV control^[2]:

• Adequate Virologic Response:It reflects no detection of HIV RNA in the bloodstream. It means that the antiretroviral therapy (ART) was a success, as the treatment managed to suppress the HIV replication to an undetectable level.
• Low-level Viremia:It reflects that the HIV RNA is detectable but present in low levels, usually between 51-199 copies/mL. This means the virus still exists in the bloodstream but does not mean the treatment failed.
• Very Low-level Viremia: It reflects the presence of very low levels of HIV RNA, even below the detection threshold (below 50 copies/mL). This means that the virus is still present but in a minimal quantity, almost undetectable.
• Virologic Failure:It reflects the failure of antiretroviral therapy (ART). The treatment could not suppress HIV replication, and there is a significant presence of HIV RNA, around 200-1000 or higher copies/mL.

All these levels are important to understand the viral load response after antiretroviral therapy (ART). Now, let’s emphasize more on different phenomena related to low-level viremia. 

When it comes to low-level viremia, two phenomena often occur, i.e., intermittent low-level viremia (BLIP) and persistent low-level viremia (pLLV). 

Intermittent low-level viremia (BLIP) is a temporary increase in viral load over the undetectable range but still within the low-level viremia range^[3]. This can happen for a short period, even for individuals who achieve an adequate virologic response and resolve without needing any treatment. The reason behind the surge is not very well explained yet and needs in-depth research to find the root cause.

In short, low-level viremia can have significant consequences, especially if they remain in the “persistent” range. 

By now, we have learned the consequences of LLV, which reflects the necessity to monitor LLV for timely treatment. There are many ways to monitor LLV, but HIV-1 RNA assay is recommended.

HIV-1 RNA assay is highly sensitive and ensures precise detection of RNA in the bloodstream. This helps to detect even the lowest RNA levels, making it easy to detect low-level viremia early on. This way, doctors can track the viral load trends and customize the treatment accordingly. However, the high detection difficulty also sets a higher requirement for HIV-1 RNA kits. This is where Sansure’s CE-certified HIV-1 RNA kit comes into play. 

The Sansure HIV-1 RNA kit quantitatively detects HIV-1 virus RNA in the EDTA plasma specimens. It showcases a high sensitivity of 25 IU/mL, uses Internal Control to avoid false negative results, and ensures timely and reliable results.Moreover, the application of advanced magnetic beads technology ensures high sensitivity and precision, accelerating the response time.

The early and precise diagnosis makes prompt and tailored treatment. As the global provider of innovative diagnostics solutions, Sansure has been standing at the forefront, developing more efficient solutions for communities and healthcare institutions, making our own effort for HIV control. Together, let’s fight for a shared future free from HIV.