In patients on ART:
- A single VL 50–200 copies/mL preceded and followed by an undetectable VL is usually not a cause for clinical concern. It should necessitate clinical vigilance, adherence reinforcement, check for possible interactions, and repeat testing within 2-6 weeks depending on ARV regimen.
- We recommend that beyond 6 months into new ART a single VL >200 copies/mL is investigated further, including a rapid re-test +/- genotypic resistance test, as it may be indicative of virological failure.
- We recommend that in the context of repeated viral blips, resistance testing is attempted.