Intermittent and sustained low-level HIV viral rebound in patients receiving potent antiretroviral therapy

Low-level viral rebound (LLVR) was identified in 704 of 2055 patients on effective antiretroviral treatment. It was followed by a value of 50 copies/ml, a 'blip', in 490 patients, whereas two consecutive values between 51 and 500 copies/ml, a 'bump', were observed in 155. Hazard ratios of viral failure were 2.01 for blips and 5.80 for bumps. LLVR is frequent and generally resolves spontaneously, but is associated with an increased risk of viral failure.