Recently, the results at week 144 of E/C/F/TAF vs. E/C/F/TDF have been published. Authors state that the treatment with TAF is more effective. They used the FDA snapshot algorithm which considers the subject as a responder if and only if the HIV-RNA is inferior to 50copies/ml at the visit of week 144. However, virological failure were excatly the same in both groups. What favours E/C/F/TAF group is that there were far more no virological data in week 144.
I m sure it is not.
Success or failure depends only on the HIV RNA level in blood at the time of the
endpoint (in mentioned example it is in 144. week, so if a patient is
above 50 copies/mL HIV RNA , no metter what is the reason, the patient will be considered as a "non-responder". This is of course a nonsens. At this time, a patient might have a serum "blip" , but before the week 144 or/and after it, inferior to this "cut-off value" (50 ml HIV RNA/ mL blood). This would be a responder in reality. Second origin of artefacts is the nature of currently available HIV RNA assays. They show variable results. Thanks for this question.
good question. I think biological variation probably has some role here.
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