More on Low (but Detectable) Viral Loads — Is Knowing This Useful?

Last week in Journal Watch AIDS Clinical Care, Dr. Helmut Albrecht reviewed a study on the likelihood of virologic rebound in patients who had viral loads <50 copies/mL on a real-time polymerase chain reaction (PCR) assay. The results were consistent with other studies suggesting that the lower the viral load, the better the virologic outcome, but as Dr. Albrecht noted: “We still do not know what these ultra-low levels of HIV RNA mean clinically and whether they should affect treatment decisions.” This week, in his blog HIV and ID Observations, Dr. Paul Sax describes the difficulty of interpreting PCR results and explaining them to patients — while also defending his choice to use this test over less-sensitive assays, like bDNA.