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Related Concept Videos

Retrovirus Life Cycles01:10

Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...
Viral Mutations00:36

Viral Mutations

A mutation is a change in the sequence of bases of DNA or RNA in a genome. Some mutations occur during replication of the genome due to errors made by the polymerase enzymes that replicate DNA or RNA. Unlike DNA polymerase, RNA polymerase is prone to errors because it is not capable of “proofreading” its work. Viruses with RNA-based genomes, like HIV, therefore accrue mutations faster than viruses with DNA-based genomes. Because mutation and recombination provide the raw material for adaptive...

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Related Experiment Video

Updated: Jun 23, 2026

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
13:58

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

Update on HIV-1 viral load blips.

Richard E Nettles1, Tara L Kieffer

  • 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. richard.nettles@bms.com

Current Opinion in HIV and AIDS
|April 18, 2009
PubMed
Summary

Viral load blips in patients on HIV therapy are often not true viral replication but assay variations or biological fluctuations. These transient detectable HIV-1 RNA levels do not typically indicate treatment failure or resistance.

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Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Patients on highly active antiretroviral therapy (HAART) with undetectable HIV-1 RNA can experience viral load blips.
  • These blips raise concerns about treatment potency and potential drug resistance.
  • The clinical significance of these blips remains uncertain.

Purpose of the Study:

  • To explain why viral load blips are not associated with long-term clinical or virological failure.
  • To clarify the nature and significance of transient detectable viremia in HIV patients on HAART.

Main Methods:

  • Review of recent data and studies on viral load blips.
  • Analysis of factors potentially contributing to blips, including assay limitations and biological variability.
  • Assessment of genotypic resistance mutations in relation to blips.

Main Results:

  • Many viral load blips are not actual increases in HIV-1 RNA but statistical variations or biological fluctuations near the assay detection limit.
  • Blips are often not reproducible on repeat testing and are unrelated to common clinical factors like adherence or illness.
  • Crucially, new drug resistance mutations do not typically emerge during these blips.

Conclusions:

  • Recent findings suggest many blips are laboratory artifacts or statistical anomalies.
  • Differentiating blips from true virological failure or persistent low-level viremia is important.
  • Once identified as a blip, transient detectable viremia should not cause clinical concern.