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Friday, November 17, 2017

1/2



This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

The amazing and promising 1/2

By Charles-Edouard!

In comments, a Genvoya® not innocent at all!

This example shows how younger people are wrong not to worry about long-term toxicity, in advance. With age comes also polypharmacy (eg statins, useless but often prescribed). Now, Genvoya® has a non-exclusive booster: it is included and boosts one of our other drugs and thus we are in overdose. This also highlights a low noise, sub-clinical, but very real, toxicity.

1/2 = half-dose or 1 day out of 2?


1/2 comes from community practice, not academic. It results from a pharmacokinetic vision, complementary to the Eclipse. Many do not understand Eclipse.

So be it... The 1/2 does not lead to remission. On the other hand, it is understandable by the Septists, that is to say 99.999% of doctors and patients. Pharmacokinetics at heart, they practice it with permissive drugs (eg Triumeq®, Atripla®). And with long lifetimes, taking 1/2 pill each day or 1 pill every 2 days is quite similar; The 1/2 is a dosage adjustment. This is the A-TRI-WEEK trial, which worked very well!

I have done Mono-DTG: 1/4 of a pill (mini-Dolu), others are doing Mono-DTG 1/2 of a pill (or even Mono-IP 1/2 dose). Certainly, my preference remains for the short cycle. I liked reduced dosage also!

Efavirenz 300 mg? Why not?


DMP-266-005 Joel Gallant Hill Ananworanich Calmy Efavirenz dose reduction
In the Phase II trial (DMP-266-005, by Joel Gallant et al., Never published ...), 200 mg works better than 400 mg and 600 mg ... And what do they chose? Well ... They didn't care ... 600 mg and fuck you all! Dosage is the responsibility of doctors, not of the pharmaceutical industry ... Facing a suicide epidemic, smart people tried EFV 400 mg: it works. For some unknown reason no one tried EFV 200 mg ...Go figure ...

At the IAS 2017 conference (video here), at minute 49:25, Pr Kiat Ruxrungtham, says: we do with 300 mg and it works very well... Here is a good idea! 300 mg !!!

Note, incidentally, in this sequence, something interesting: they have done tests and offered to patients who have CNS problems with EFV 600 mg to reduce down to 400 mg without even a dosage. And it works ... Which leads him to say, in the same wake, that it also works at 300 mg. Question: If it works without problem at 300 mg, why restrict oneself to patients complaining of CNS problems only?

What synergy???


Phase II data is available here: Dose Optimisation: A Strategy to Improve Tolerability and Lower Antiretroviral Drug Prices, by Hill, Ananworanich, and ... Calmy! (Sic)

Synergy, a heuristic concept, with no identified mechanism, claims that some combinations work better than others. However, the dosage is never reconsidered. Thus, 3TC is set at 300 mg from its early introduction. It dates back to AZT / 3TC Bi-Therapies. Nobody ever had a commense reflection: well, with Efavirenz, maybe we can reduce 3TC a bit. As If ... There are some clever people, who have seen that Cobicistat (an hepatic metabolism inhibitor, often named: EVG booster) ALSO boosts TDF, and ask the question why do not we reduce the amount of TDF at the same time? Simple, doing so it brings not profit to Gilead.

There you go: Effect of cobicistat on TDF: what is true for TAF may also be true for TDF

Especially since they will effectively reduce when switching to TAF. And may be, they already have a me-too copy of 3TC (I bet you they will add another Fluor), some sort of 2F-3TC, that they will come out of their magic hat and market as an all new combo, less dosed.

And no one to look back and say, "Oh, but we used 3TC abusively, at 300 mg, for years without asking any questions."

300 mg EFV + 150 TDF + 100 F-3TC: a poor man's Caviar


Kiat Ruxrungtham Efavirenz IAS 2017 dose reduction
It is clear that, today, patients are very well treated in Thailand, probably better than at home! Intelligence is not reserved for us. So Siamese or Chinese clinicians will uncover the hidden Gral: they are at work there, without you noticing. Then will appear a combo composed of 300 mg EFV + 150 TDF + 100 F-3TC (or 150 3TC), to take twice daily for 1 year, followed by 1 per day ad-vitam. Maybe even 200 mg EFV ... Why not?

And we can only then note, once again, the inanity of the ANRS. We have no ideas, they say. Yet, alternative proposals are moving forward.

You will be fattened with injectables at 10,000 Euros per year, whereas they will have nice and effective treatments at 50 Eu / year. That is crazy! After we are being told that French workers are not profitable, they are lazy! So they cut jobs, cut jobs, cut jobs ...

No need to go to Thailand: sooner than never, Greeks, Ukrainians, Cubans, Venezuelans will get at it.

In the news ...


Does Prep flops? Only 5,000 Prep users! Activists are highly disappointed! So they go at it again ...

Interesting article by Carole Petit: puI'll publish a translation real soon!

Universal, mandatory vaccination is voted: when will come mandatory treatment? Not before the arrival of injectables... So this is coming. Here again subsidized Seronegative activists will be at work!


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Sunday, November 12, 2017

Guidelines are fooling you



This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Treat-Early: How Guidelines are misleading

By Charles-Edouard!


The doctor does not analyze the ASAT / ALAT for fun! The liver is on the front line and receives the most of toxicity! If allowed to, toxicity sets in and becomes irreversible; and if we do not want to let it do, what do we do ?! Overprescription is a real martyrisation of women's body. You were asymptomatic and immunocompetent, and, abracadabra! You're hepato-deficient ... Bravo!

Treat early! Without treating better ???


Updates of the Morlat Report [aka French Guidelines] are published here. The most recent discuss initiation of a first antiretroviral treatment (October 2017). We will discuss here what is on page 4.
Morlat ANRS vih HIV OMS IAS EACS recommendations
Short reminder: the question is to know at how many CD4 it is recommanded to initiate treatment. Before it was less than 200, then they extended the indication to less than 350 and less than 500, then, now, less I-do-not-know-what: everyone is concerned. In a review (Should HIV therapy be started at a CD4 cell count above 350 cells / μl in asymptomatic HIV-1-infected patients?), C. Sabin showed that, in the area with very low risk, studies were indecisive (this which is hardly surprising when the absolute risk is so low). She asserted that only a comparative, randomized, trial would make it possible to decide. She considers that the START trial fulfills this role. Legitimate hope if the trial had not been, by construction, biased. The START scandal is multi-faceted: it will be our summer 2018 series! So we are not going at it here: just remember that this trial is biased, by construction.

The Morlat Report concludes in favor of undifferentiated, early treatment.

Treat early? Bullshit! Shouts the European cohort


The most recent study, the HIV-CAUSAL cohort, under our tropics, concludes to the futility of treat-early. Nobody ever mentions toxicity, obviously ... In Europe, in the area of minimal risk, the individual balance between individual clinical benefit and medico-pharmaco-induced toxicity (), is not at all in favor of treat-early. As a proof, read this case, of a patient, deceased, horribly, due to pharmaco-toxicity, in 2009.

They conclude: the beneficial effect is less than in recent randomized trials. In fact it is zero: 5j. of additionnal life in expectancy! However, in its latest version, the Morlat report omits, shamelessly, this mega-study (55,000 patients!), published in The Lancet HIV(2015). Maybe they do not read the LANCET HIV...

How did we get there?


To bias START, they surreptitiously introduced patients at high risk (pretreatment) among others, at microscopic risk. They are necessarily tipping the scales towards early treatment.

Morlat, using, as justification, the ANRS-TEMPRANO trial pushes it one step further: we will use patients from a geographical area (Senegal) with high endemicity of tuberculosis. Tuberculosis, or even its suspicion, is an indication for prophylactic antituberculosis treatment: Tuberculosis greatly raises the risk. How do we know that? Exactly thanks to the trial ... ANRS-TEMPRANO! Adding insult to injury!

The trial demonstrates the benefits of antituberculosis prophylaxis. And they would like us to believe that they recruited HIV patients at very, very low risk! It's amazing when you think about it!

Actors of TEMPRANO write an article, and, in very civilized terms (they work for ... ANRS ...), give the keys to this incredible trickery (trickery for the French, for the Senegalese, unfortunately, this is real).

The article: Antiretroviral treatment regardless of CD4 count: the universal answer to a contextual question. It reads: [...] This difference is mainly due to the geographical context of morbidity. [...] [the benefit] is especially true in low-resource settings where TB and other bacterial diseases are highly prevalent.

Morlat ANRS vih HIV OMS IAS EACS recommendations


This is a disputed benefit, probably zero. If this is all the more beneficial in areas of high prevalence (TB, etc.), it is therefore, on the contrary, much less beneficial in low prevalence areas. From their point of view (Senegal), the authors welcome a universal recommendation, while warning us that, in the North, this benefit is probably illusory.
TEMPRANO Morlat ANRS tuberculose vih HIV AIDS TB


Of 40 million infected, 2 live in the North. For 95% (the South) an indication extension is beneficial, while it is zero (or even negative) for the 5% that we are. In misleadingly mixing two very different health risk populations, in proportion 95% - 5%, it is obvious that the decision, taken on the average of this amalgam, is actually detrimental to us. To illustrate that , I propose to take the TEMPRANO table, and subtract tuberculosis and invasive bacteria events, if you consider that it is a risk to which you are not exposed. The TREMPANO table also indicates that tuberculosis-disease has caused the death of 8 patients (estimated) (you are told that these are patients at very very low risk ...).

Event Differed Treatment Early Treatment
Tuberculosis57 28
Invasive Bacteries 42 14
Other10 6
Deaths (*)26 21
Total 135 69
Let's remove what is endemic there (Tuberculosis and invasive bacteries )
Corrected Deaths (*)20 19
Corrected Total 30 25


(*) You will notice, by the way, that they have counted patients twice: the tuberculosis, and the death that follows! (But that does not shock anyone!) We will also remove these deaths proportionally (for lack of better). There are 8 deaths (5 + 3) attributed to tuberculosis at the 57:27 ratio, ie 2: 1, so 6: 2. I spare you the calculation of small p, the risk, if any, small, with an absolute risk, very small (we are in Senegal ... Not in Pithiviers)

The average French patient, never exposed to the risk of tuberculosis bacillus and other endemic bacteria is at zero risk. The young person, without particular comorbidity, without significant immunodepression will be inflicted a triple therapy, daily, over a dozen years in excess, to avoid, hold your breath: the Senegalese tuberculosis!

Treat early: an ICCARRE booster


Think what you want, even say that they do not care a damm, you can't do anything: indeed the Morlat group, unlike the HAS, is not justiciable: you can't sue them! (HAS you can ...); the HAS remains on the 350 threshold...

My doctor, once confessed to me, long after, that he has never seen any PCP or Kaposi at 500!

This leads to ostracism towards patients-who-are-not-fooled: they are quickly excluded! Yet, if we had told them about ICCARRE, 1/7 ... Treat-early, if accompanied by Treat-better is more attractive.

We will see the economic, societal, liberticidal, coercive, toxic consequences in a future post ...



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Saturday, October 21, 2017

Quatuor Trial has started



This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Quatuor Trial has started

By Charles Edouard!

Shortages: here is a testimony from Greece:


Today in Greece, Venezuela (rich country), Russia, Ukraine, soon in Spain, they have ARV shortages. Here is for Greece, and Venezuela.

Soon will come sanitary migration? Shortages where you live or in France ??? Which does not produce ARVs? Biggest producer of butter and we have shortages at the supermarkets (I did not believe it, but I saw, and made my stock). In the USA, where IRMA has devastated the ARV producers in Puerto Rico, Florida is in trouble... You have seen the circus with Levothyrox. We must anticipate!


ANRS-Quatuor officially announced


Quatuor Quartet Hiv vih cure FOTO Truchis allègement ANRS trial
I have already posted Quatuor and Strategy # 1, followed by
Quatuor and Strategy # 2, and
French Guidelines just killed Quatuor

See the dedicated page (see comments and discussions)

It officially appears, for the first time, in August 2017, and is registered under number NCT03256422. Last week, (2017-10-04), ANRS published, on its site, the technical sheet, so, this time, it is a go!

You will hardly find any news in your usual medias: does that surprises you ?

ANRS-Quatuor and veterans


A totally false idea is circulating: aleviation should exclude veterans. A priori, we can think this way, but science shows the opposite. Science and trials serve to defeat misconceptions that are harmful to patients: the earth is not flat! Veterans are eligible. You have to pass genotype selection, maybe a bit problematic. In any case, it is enough to refer to the datasheet: there is no restriction on age, NADIR CD4, Zenith RNA, CD4/CD8 ratio, or reservoir. Nada.

ANRS-Quartet: better late than never?


The saying goes ... The reality is much more distressing: 15-20 years late! A very first article appears here, in 2000, by Act-up. So no! One can not let the thing pass, forgive, as if nothing had happened. Patients, thus blundered, will be entitled to claim accountability to retardants: Prs Delfraissy, then director ANRS, Molina and Katlama, as animators of the AC5 committee (AC = Coordinated Action, coordinated with ... with ... Follow my eyes...)

The demonstrated ability to do ICCARRE (with frequent VL) by oneself (without a doctor) has probably played a positive role in confronting ANRS, a mere retardant. Waiting for ANRS is a mistake!

Do not forget, do not forgive, the fault is too serious! Of the same order of magnitude as the contaminated blood scandal. People have died of bad medication: never forget it!

ANRS: nothing in the pipelines... So what ???


Quatuor Quartet Hiv vih cure FOTO Truchis allègement ANRS trial
The new ANRS director, Pr François Dabis, says, refering to aleviation, that there are no new ideas in the pipeline. What a great simpleton! Does he not realize that when one has ZERO intrinsic failures in a trial (ANRS-4D), this means that there is no valid argument for patients, still very demanding, to stick to 4/7. Which argument against whoever would like to go 3/7. If well performed, the risk, at 4/7, is Zero (or epsilon, we will see): no risk, we can go further: this is a normal reasoning, which will emerge among patients: do not initiate an exploratory trial is guilty or imbecile, or both... ICCARRE 1/7 already gives us some clues...

A research organization, that does only does validation trials (for the great benefit of Big Pharma) of techniques already explored, and even already authorized, is ridicule!

Quartet, Stribild® / Genvoya® and Viramune®


I only know one attempt, ill-planned, of 5/7 under Stribild®: failure! Conversely, Nevirapine (NVP) works: why exclude it? Virology doesn't lack morons ...

ANRS-Quartet: I do not participate, what to do?


There is no moral, ethical or legal limitation to do for oneself. Even more, the French Guidelines do authorize 4/7. So, with or without a doctor, especially with frequent CV control, you can move forward (see the Practical Guide). Refer to the Quatuor Inclusion Conditions, or ANRS-4D. The ANRS-4D data sheet has disappeared from ANRS website (sic!) ... We have a copy in the complete file.

It should be remembered that nobody has the exclusivity or the privilege on personal experimentation. Nobody ... The advantage of ICCARRE is that the patient has all the tools available (try self-experimenting with injectables,if you can: you do not have access).

Let's compare the advance Autonomous mode, with the trial mode:

Importants points If included in the trial Autonomous mode
Inclusions criteriaEnforced (scrupulously?)To follow scrupulously
Genotype reading mandatory preferred
Eligibles TRI Almost all (exept NVP) Almost all (NVP: OK, EVG : No)
Is is known beforehand No but small (ANRS-4D) No but small (ANRS-4D)
Accounted for Yes No
immidiate start No Yes
autorized by... ANRS french Guidelines (CNS/ANRS)
allows for stock No Yes
Donations (PreP...) No Yes, this is generous
Avandtages Includes Stribild®/Genvoya® Includes NVP, immediate start
Disadvantages delayed start / no slots frequent VL cost


In the news


flu vaccine: a warning from Dr Dupagne: The dangers of the flu vaccine are not those that you think. I will not get that shot!

Legal opioids: In the USA, the explosion of lethal overdoses with (illicit) opioids logically follows the over-prescription of (licit!) opioid drugs, largely encouraged by the medico-pharmaceutical mob. When in France?

Levothyrox: they suddenly switched 3 million patients (probably 1-2 million suckers): 15,000 report side effects; The ANSM blaims doctors for not adjusting dosage (cf Le Monde): yes, many are morons: one only realizes now?

Short Cycle Meeting: by amis d'ICCARRE (Oct. 12). Good idea, to be renewed...



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This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Tuesday, October 10, 2017

Raltegravir 1200 mg



Summer 2016: we offered a serial: ANRS-4D and the cheaters
Summer 2017: we will debunk DOMONO: It starts here


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Towards Raltegravir 1200 mg: One thousand two hundred !!!

By Charles Edouard!

People eventually understand, which gives this:

There we go! One more who understood! Overmedication creates damage (sometimes fatal), and de-escalation is on the way. It has its enemies: the medico-pharmaceutical mob! Well, what is happening on Raltegravir will allow us to expose ambitions, mechanisms, tricks, actors and the lack of patient protection. Let's start by drawing the landscape...

Reminder: in our hit-parade towards 1/7, Isentress® is one of those to avoid


Isentress®: a problematic pill


Isentress® contains Raltegravir, the first (non-exclusive) Integrase Inhibitor, marketed in 2007. A revolution. Merck has tens of thousands of molecules. They played the mule (method now obsolete), have prepared as many test tubes as molecules and tested for a possible effectiveness against HIV. They find a candidate (diketo acid), ask the chemists to improve a little. One ends up synthesizing a molecule. And there we go ...

There is a catch: the molecule passes the stomach wall but not the intestinal wall. It is annoying: if the drug has not been well disintegrated in the stomach, the small remaining stone goes to the intestine, where it no longer has any chance to enter the bloodstream. Unlike NVP or Videx, among others.

If you miss your absorption in the stomach, there is no catch-up (the intestine): you succeed and you have your plasmatic dose, you miss and you have only half (at best). To do 365 times / year! In the same patient, there will be days with and days without ... Big problem!

We will increase the success rate by doubling the number of attempts: and Hop! There we go to Twice a daily (700 dosing per year!), It is a Royal Pain in the ass, but in 2007, we accommodate ourselves.

Obviously the dose is also maxed: 800 mg / day: the highest dose among usual ARVs!

But as one puts a lot into a tablet (400 mg), the tablet is very compressed. It is hard as a pebble, which will make things worse ... The pebble diffuses in the stomach in a very variable way, which is the only opportunity. Shit!

But hey, the manufacturer does not care, patients just have to swallow the shit: we take our money and you get lost. And above all, out of question to admit any error.

In maintenance, the 3 modes of dosing


Merck method: Twice a day, 12 hours apart (400 mg then 400 mg). A small study shows a very slight benefit to this method, and as the dosage is not the responsibility of the pharmacist, but of the physician, Merck plays conservatively. The Merck-boys will be deployed to spread the voice of their master. Merck, knowing the cause of the problem, has already planned to reformulate the drug ...

German method: very popular in Germany. Practitioners allow their 'observant' patients (since Germans...) to take the 2 tablets at 1 time. Overall satisfaction ... The practitioner is happy, the patient also, having the impression of having / being personalized (thus loyalty).

'Italian' Method (abusively known as Charles-Edouard's, I have only published the relevant info here, also see here): It consists in chewing before swallowing, which allows to take all in one go!

I have buddies who tell me 2x400 mg, in 1 time, My doctor tells me in 2 times (in 7/7). This team of Italian clinicians say 2x400 mg, chewing, in 1 time, in 7/7, and Leibowitch, it says 1 x 400 mg in 4/7! What a diversity! (with no significant difference in effectiveness).

Mandatory or influenza vaccines, Levothyrox®, RAL 1200 mg: a hysteria


With the Levothyrox® scandal, one could observe the morgue by the manufacturer (Merck, again), the State authorities, who deny, in block, any side effect. Three million French patients take Levothyrox®, and are despicable imbeciles proportionately! Obviously, there is over-prescription! The medico-pharmaceutical mob has no limits!

Same for vaccines, we will vaccinate our small frogs against Hepatitis B (multiple sclerosis will become an infantile disease). A child (made) deficient, it's for life! Influenza is a benign disease, and your cellular immunity (CD4) has nothing to do (or so little) with your humoral immunity (which protects those who have had it, or its vaccine, 2 or 3 times): no influenza vaccine for Charles-Edouard! (replay this interview)

Then Merck works towards a RALTEGRAVIR at 1200 mg. What made Merck move? The arrival of EVG (Stribild®) or Tivicay®, which are in a single dose per day? Well no, they are announced since 2010 ... The loss of market share is real. And especially the loss margin is even harder, with the arrival of generics: we must keep positions by giving a boost to patents; And since they did not invent anything, well they will propose the once-daily by imposing 1200 mg!

Those who practiced the German or Italian way will find themselves at the wall.

Reminder: anyone interested in remission (relative, of course) should proscribe RAL.

So they will double the dose! Doubling ?? Wait, Charles Edward! From 800 mg / d to 1200mg is quite already violent, but not quite double ... Yes, yes, double ... You will understand ... It will be for a next time ... we will follow this as it will be droll and ridiculous!

Well, the case is advertised in the Lancet: Raltegravir 1200 mg once a day versus raltegravir 400 mg twice daily. Good reading!

Have a good Week, good fuck and do not abuse of meds/drugs

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Comments


Steve 22 Oct. 2017


Charles-Edouard! 30 Oct 2017




Sunday, September 24, 2017

2017 Treatment hit parade



Summer 2016: we offered a serial: ANRS-4D and the cheaters
Summer 2017: we will debunk DOMONO:it starts here


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

2017 Treatment hit parade

By Charles-Edouard!


Well ... My grandmother would have said "Cancer fore sure!". Well, we also have a new thing: Alzheimer ... My good old doctor, over-medication conscious, always said: "We would like to remove one of them, but which?"
My experience was taking this path ... Why say "alleviation is not for me"? We would like to say: quite the contrary!


My own Hit-Parade 2017


There are various rankings of meds (eg Morlat). One of the most relevant is the Spanish ranking.

Ours is not a recommendation, it is made exclusively from the perspective of refueled remission: the 1/7 (at least ...). These are, at most, considerations to have in mind when discussing with your doctor. Especially since the genotype (mandatory in France), may limit your options ... The ICCARRE exploration invalidates treatments based on IP or Isentress®, from 3/7. Obviously, there are ways simpler than others to reach the 1/7, and benefit from our predecessors, regardless of the medico-pharmaceutical propaganda.

 Classics (see patents) 
 1 NNRTI  + 2 NRTI  for 1/7, we may add, at 2/7  comments 
 Efavirenz  TDF + F-3TC  Abacavir (Ziagen®) or Videx®  This is Atripla®
 ABC + 3TC  TDF or TAF (Viread®) or Videx®  
 Nevirapine  TDF/F-3TC  Abacavir (Ziagen®) or Videx® see bellow
 ABC + 3TC  TDF or TAF (Viread®) or Videx® 
 Modern ones  (usage for 1/7 is being explored) 
 1 INSTI/NNRTI  + 2 NRTI  for 1/7, we may add, at 2/7  comments 
 Dolutegravir  TDF/F-3TC  nothing ?
 ABC + 3TC  nothing ?  This is Triumeq®
 Rilpivirine  TDF + F-3TC  Abacavir (Ziagen®) or Videx®  This Eviplera®&/Complera ®
see below
 ABC + 3TC  TDF ou TAF (Viread®) or Videx® 


Know what to avoid


In the perspective that is ours, discuss with your doctor to avoid: PIs (Kaletra®, Prezista®, Reyataz®) and the 'older' INIs: Isentress®, Stribild® / Genvoya®)

Special case Nevirapine


The group of 'self-proclaimed experts' (we did not say independent experts ...) zapped NVP (document EACS). They also zapped their conflicts of interest declaration (Well ... While they are at it...)

NVP has limitations at initiation and gradually gets excluded from general recommendations. On the other hand, for maintenance, there are no such limitations. We have to make sure we do not have an allergic reaction, but, that's like everything else. This is Leibowitch's favorite molecule for his patent and the path to relative remission (1/7). You may want to switch to NVP using the NVP-switch-kit. As the path to 1/7, using RPV (or even DTG), is not chartered, yuo may want to return to ICCARRE orthodoxy. In switch mode, there are efw to none documented ontraindication. Once daily, it is generic. No medical congress in the West Indies ...

Special case Rilpivirine (Edurant® / Eviplera® : Complera®)


It's very much in vogue and has worked very well in 4/7 (ANRS-4D trial); it has not been explored further. To return to chartered routes, you may want to switch to NVP, using the NVP-Switch-kit or wait for a hypothetical trial in 3/7.

Special case Raltegravir (Isentress®) Elvitegravir (Stribild® / Genvoya®)


HAS has said and reiterated the low genetic barrier of Elvitegravir. In ICCARRE-1, Raltegravir 'trips' at 3/7. So, with that, if you think to go peacefully to 1/7, you have to explain! Moreover, the mere use of RAL or EVG creates an identified, known and published over-risk for DTG in reduced mode (Mono-DTG, or even, by extension, Bi-DTG and DTG / x in X / 7): this is the Achilles' Heel (Prof. Katlama). The bag is full and, for a 1/7 perspective, does not sound good! Their presence at the top of recommendations, not justiciable, open to abuse, speaks volumes. One may be able to correct for this, before considering 3/7, but may be not with Dolutegravir. It is still very limitating!

Special case of Protease Inhibitors (Kaletra®, Prezista®, Reyataz®)


In ICCARRE-1, PIs associated with 2 NRTI 'trips' at 3/7 ... So it's not ideal to move towards 1/7. No? If you can, you may want can go back to ICCARRE's orthodoxy by substituting an NNRTI, but then why did not we do it from the beginning? As an alternative (prospective), the combination of Tivicay ® (DTG) with Prezista ® or Reyataz ® is currently being explored in an x ​​/ 7 perspective (see here).

Special case Videx ®


Stock it! It is already no longer available in Switzerland ...

Counselors are not payers!


Beware of these so-called 'recommendations' issued by 'authorities' who are not and who are exempt from the ire of Justice and Democracy (Europe, unfortunately, has also become this too...). The recommendations of the EACS are irresponsible, in the sense that no one assumes the moral, sanitary or legal responsibility: it is to medicine what an advertising report is to journalism.

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Thursday, September 21, 2017

We won!



This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Summer 2016: we offered a serial: ANRS-4D and the cheaters
Summer 2017: we debunk DOMONO: it starts here


We Won!

By Charles-Edouard!

guillaume dustant mort sida bareback intoxication vih no-kapot MST Hotel-Dieu erik remes act-up
With 120 beats per minute120, the DUSTAN / REMES vs ACT-UP controversy resurfaces. About the death of DUSTAN, Wikipedia tells us:
Autopsy revealed: involuntary drug intoxication resulting in death. So stupid! By 2005, alleviation already exists... Unintentional drug poisoning causing death: see, this is why I am indebted to Leibowitch.

At first, it goes well, then the list goes on, the Rx holds on 2 pages. We add a little, to help a brains that escapes you. The great reaper lurks... The doctor, prescriber of death, will not be worried. Medico-pharmaceutical mob avoids accusation... But you, will you avoid drug poisonning?


Omerta: a reality


They screamed "Scandal!". Rightly so: re-read this post. The presentation by Leibowitch (4/7 and 1/7) was deplateformed, in last minute, without a word of excuse, by a committee co-piloted by ANRS (our good friends!). Once again we saw the power of the anti-ICCARRE clique: friendly and fraternal pressures, obfuscation, and even Stalinist retouching.

Obfuscation consists of mixing the nuggets and the scraps. For a blow snow job, trust C. Katlama! They mixed 4/7 among nonsense, so quickly forgotten.

Stalinist retouching, as we shall see later, consists in suppressing events afterwards. Thus the online video on youtube is amputated of Dr. Turkova's presentation. Well, yes ... They don't make our life easy.

The trick was to entrust the presentation to a pediatrician, without direct experience in 4/7, 3/7, 2/7, 1/7 (relative remission). A scientific congress, in Paris, has ignored the refueled remission, albeit fully demonstrated! And, of course, everyone congratulates microscopic advances... Donkeys scratch each other's backs ...

ICCARRE and the MORLAT recommendation, in front of the world


Download the slides by Dr. Turkova, the complete session here.

The Doctoressa, who, by her own admission was incompetent to speak of the 4/7, was therefore informed, in extremis, of key developments: ICCARRE and the MORLAT recommendation. It was necessary to urgently provide a translation of His Morlesque Holiness, which fortunately was already done. It costs me enough of my time so, when it is useful at the right time, I'm quite happy.

IAS 2017 Paris ICCARRE french guidelines hiv aids Turkova breather Quatuor Anrs



So ICCARRE was exposed to a world, amazed and enthusiastic! The recommendation of its use, MORLAT and ANRS (sic!), was revealed to a world, previously ignorant: Fiat lux! In the scorching torpor, our enemies allowed themselves to be overwhelmed.

The ICCARRE victory and unanimous ovation


The room is full! It's hot! Quickly, they open, not only one but, several adjoining rooms, with television broadcast (broadcast which will be truncated in the official release!). They are under shock! Ovation at the evocation of ICCARRE, general applause!!!

IAS 2017 Paris ICCARRE french guidelines hiv aids Turkova Katlama allegement
Let us not be mistaken, our victory is one of a battle in which the war is going on elsewhere ... We shall have to fight again in a guerrilla war maintained by those who fought against us, in the past, but it is only a question of time ... The final victory is assured, and quasi-remission for all is within reach.

As proof, the ignoble mob-in-white-coats tries to drown the ICCARRIAN universality in a so-called personalized medicine, on a case by case basis, which would be onerous for all. Certainly the Eclipse is variable, but since it lasts at least a week, for the super vast majority, please reserve 'personalized' medicine for some badly treated patients.

Leibowitch, a sought-after, revered, congratulated and even rewarded participant ... He will receive from the hands of Dr. Sidibé, Executive Director of UNAIDS, a magnificent badge. Here is our decorated Leibowitch, lacing up his ribbon beside his Legion of Honor.

Bareback also wins


120 battements minute mort sida bareback intoxication vih no-kapot MST Erik remes act-up
Nearly one hundred presentations about PreP! The medico-pharmaceutical mob has not been idle! Jubilatory ejaculation for barebackers! Sure, Act-up does not find this funny... Their nostalgia ruins our lives!

So, explain us that this PreP attack is not a posthumous victory for barebackers...

Ah, I see ... You would like to know who is this doctor co-responsible for the death of DUSTAN ... Yes ... S/He is still active... We will discuss this one next time.



Feel free to comment, to like to share and to use

Have a good Week, good fuck and do not abuse of meds/drugs



This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Sunday, September 17, 2017

Mono-DTG: all is fine



Summer 2016: we offered a serial: ANRS-4D and the cheaters

Summer 2017: we will debunk DOMONO:
- Dolutegravir and R263K
- R263K: new scenario (DOMONO)
- N155H: new scenario (DOMONO)
- Nevirapine and Mono-DTG Switch: the Hunchback Trap
- calculation error in the primary hypothesis
- DOMONO and the benefit for the patients (not for BigPharma ...)


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Mono-DTG: a winner

By Charles Edouard!

In DOMONO, we will find the same failure rate as in BMM + P. Mono-DTG is of little interest to us. In a 1/7 perspective, based on Tivicay®, it can serve as a preamble to a remission strategy. Indeed, if one succeeds in Mono-DTG, one is perhaps in favorable conditions for the ICCARRE descent, either in Mono-DTG or in Bi (BiCycle strategy).


The DOMONO trial overrides proper selection and advice for better bioavailability!

Your Mono-DTG chances can be greatly increased with our Mono-DTG Practical Guide.

No harm to patients


As for the failures in Mono-IP (strategy to be avoided), a viral escape is clamped down by simple return to the initial triple therapy. Patients who fail will have, at the most, to go back, where they were already. And for those who succeed it is just so cool!

In all participants, ART was reinstated and CV was <50 within 12 weeks in all! (see here). The authors of DOMONO (results here), and BMM + P analyze that the attempt at Mono-DTG results in no loss of therapeutic option. And that's what counts!

HUGE benefit, except for ViiV Healthcare


We must admit that, for the time being, the idea of ​​a cyclical strategy (eg 4/7) does not make a good impression on people: they do not understand it, they are suspicious of it. The septists are septists to the marrow, to understand the Eclipse will be difficult for them. At the same time, the desire to take better care, with less, remains very strong: a bi or a Mono-DTG can be an intermediate solution.

The real prejudice is for those who do nothing, and stay in TRI ad vitam.

My readers testify: Mono-DTG is a real relief! I confirm!

A reader reminded me of the benefit when s/he went from Stribild® (4 molecules! And meal obligation) to Mono-DTG, so easy, so small to take, and, above all, so much better tolerated!

What to say to this 72-year-old patient, diagnosed late, with other health problems, CD4 = 1 (!), treatment naive , and that Dr. Lanzafame put under Mono-DTG, successfully? What to tell him? That he should have taken an infamous TRI, then wait a year before doing an ICCARRE descent (as if it were proposed to everyone!). Of course this patient is happy... Because seniors, under 5 ARV molecules, do exist!

Nevertheless, the patient has a choice! Just ban Mono-DTG because of a poorly run trial is ridiculous! Those who have been opposed a rebuke (read here) go elsewhere and they are right!

DOMONO is a useless trial, just good for the trash


It is a bad attempt, not just because I find the conclusion ridiculous and its interruption unjustified, but because it teaches us nothing ... Nothing at all ...

Where is the post-hoc analysis of the Achilles heel (yet incontestable, cf BMM + P)?
Where is the phenotypic (not genotypic) test for patient # 1, as promised in Oct. 2016?
Where is the critical analysis of mutations? And to forget that the R263K is beneficial ...

Ah ... We could identify the Hunchback trap... Well... We?... It's I ... Not the authors ...

Where is the benefit / risk analysis while the benefit is enormous? And the prejudice nul?...

Mono-DTG, it's still a so much better than MONO-IP! (strategy to be avoided, for that matter)

Practical Guide Mono-DTG



The Practical Guide (4/7) has moved the lines: it is copied here or there, and the Morlat recommendation boosted it well beyond my expectations

So I am writing a Practical Guide for Mono-DTG, confident that Morlesque oukase, will go, like DOMONO, to the trash.

Bicycle and MonoCycle Strategies


The Eclipse equation is valid in an efficient medication context, without imposing that it is a TRItherapy

The Eclipse exists whenever the treatment is effective. It does not prejudge "synergies" (there, one will have to explain me the whys and hows ...). The Eclipse results from a burial phenomenon (we'll get to this soon ...) that DTG promotes.

The Eclipse Equation, the deep burial of the proviral sequence, is been worked on, and we can begin to consider a long eclipse for all.

Today, there are enough individual testimonials of success under Bi or Mono-DTG cycles, to be interested in the issue. Especially since the Septists, anti-ICCARRE in their genes and interests, will soon jump on DTG + 3TC or DTG + RPV to lock their patients again in their everyday life straitjacket.

The temptation is too appealing in their camp: it is also in ours!

When you have an Eclipse (and who does not?), why not take advantage of it?

We evacuated DOMONO, that the Medico-Pharmaceutical Zealots will thrive on. Let's put this bad trial to the trash ... Too happy that we have learned some lessons, and better armed to resume our path to remission (refueled, of course...) by integrating this modern and relevant tool: DTG.

In the next few weeks, I will outline what a BiCycle Strategy would be (DTG / x in 4/7, 3/7, 2/7, 1/7 ...) or even MonoCycle (that then rejoins HypoDolu)

These many years to observe the inanity of ANRS convinced me that one does not enter the remission path by kowtowing rue de Tolbiac. Adios non-amigos!!!

We'll resume our normal schedule... Good Weekend, good fuck, not too many drugs, huh ...


Thursday, September 14, 2017

DOMONO and the primary hypothesis

DOMONO and the primary hypothesis

Summer 2016: we offered a serial: ANRS-4D and the cheaters

Summer 2017: we will debunk DOMONO:
- Dolutegravir and R263K
- R263K: new scenario (DOMONO)
- N155H: new scenario (DOMONO)
- Nevirapine and Mono-DTG Switch: the Hunchback Trap
- calculation error in the primary hypothesis
- DOMONO and the benefit for the patients (not for BigPharma ...)


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.
At first, we provide a Google translation, then we work on proper translation, which will come soon.


Patients lose confidence in medicine ...


Overmedication is on! Be confident... Inhibitors are not toxic, taking a treatment in advance is safe. Then comes the obligation to get tested, then that to get treatment. The same drama as with vaccines! And, it is much more profitable!

To make believe that it is necessary to treat at any level of CD4, one has adulterated a trial: START. By construction, it could produce no other result than the advantage to early treatment. The trick? Introduce a large group of pre-tuberculosis patients. If we exclude them, the result is reversed, as had been shown by years of British practice to initiate only below 350 ... CQD


S230R in DOMONO


The S230R mutation is associated with resistance only if it is associated with others. All of them do not necessarily confer resistance ... According to Stanford, here: S230R is a non-polymorphic mutation [...], which seems to have minimal effect, if any, on INSTI sensitivity.

It is not causal in the VL rebound, and, alone, does not confer resistance (cf: here). It has a NUL score for DTG, but not for RAL or EVG (see here). Achilles' heel? Go figure...

S230R can only be identified as RAM (mutation associated with resistance) only if it is not alone; But here it is alone! So, not a RAM. VL rebounds, it calls for action. Which? A resumption of TRItherapy (Eviplera®), as the authors did ? Or an addition of 3TC, as they recommend at the end of the trial? In the long run, ICCARRE still remains possible.

Here, it was not a RAM justifying a trial interruption...

More than 50% of failures are preventable


As with DOMONO, the BMM + P study excludes patients who had failed INI; BMM + P shows that more than 50% of failures are avoided by using the Achilles' Heel selector, which DOMONO does not. Unsurprisingly, we get as many failures as in BMM + P? Mostly avoidable failures!

The primary hypothesis is validated

Despite this, the non-inferiority hypothesis is validated! If the Morlat group is consistent, it could allow Mono-DTG in its next revision ;-)

Lorgeril explains, here, that we must define the primary hypothesis, in advance, and stick to it! And concludes: A trial stopped prematurely is worth no shit! Trash !

Fatal error: the undue safety interruption


The trial has been interrupted due to a safety trigger, on the pretext that the number of RAM exceeded the number of allowed RAMs, as per predefined safety conditions. Predefined conditions that we could not find anywhere... It comes out of nowhere: it is done with a wet finger.

This is quite debatable: indeed, the S230R, seen at S30, is not strictly speaking a RAM. But the two other resistances N155H and R263K are seen at S60 and S72, ie while the patients, technically, are no longer part of the study, which lasts for 48 weeks.

The error originates from that patients remain in the study beyond the time allowed, without releasing the bridle. This safety constraint is calculated from a permissible frequency, say 2 per year, that is multiple by time (1 year), which gives 2 ... But if the study lasts 2 years, then the trigger should be set at... 4.

Why are there S72 patients in a 48-week study??? They had difficulty recruiting: the recruitment was spread over approx. 1 year!!!

The main reason for stopping the trial was that there were too few participating centers, and that the investigators, who have defulted their expectations, had not reassessed the safety conditions to take into account the delay. Hopefully Hocqueloux, in MONCAY, who also has trouble recruiting, will be smarter!

All the statistical analyzes are based on the (doubtful) hypothesis that resistance is random, with randomness constant in time ... Therefore, advancing the date of initiation of treatment increases the time the patient is exposed to risk of resistance or suicidality. But, no one talks about it ... Of course...

The summer is coming to an end, our summer series will have one last episode, and then it's back to scholl, full lights on our victory, remissions, post-treatment controllers, bi-cycle short cycle (BiCycle Strategy), new results with Mono-DTG ... Oh, we'll have fun!

Hurry to the sea, the beach, sun and Love!