More Reasons to Reexamine the Definition of Viral Blip During Antiretroviral Therapy

Abstract

that can be used to interrogate subterranean virologic events is increasing, seemingly daily. Consequently, the magnitude of transient viremia that can be considered minor or inconsequential (ie, a blip) needs continual reexamination. In the elegant retrospective observational cohort study by Grennan et al, published in this issue of the Journal [3], viral blip was defined as a transient HIV-1 RNA increase to 50‐999 copies/mL after attaining ,50 copies/mL during ART. The investigators achieved their objectives of (1) determining correlates of the transient HIV-1 RNA increases and (2) determining the impact on virologic rebound. Incidentally, their results also strengthen the need to narrow the definition of viral blip in clinical and research domains. A strength of Grennan et al’s study is