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Saturday, November 19, 2016

Four days ON

Four days ON, three days OFF on prime time state TV
This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.

ANRS-4D on prime time state TV:
a commented transcript

By Charles Edouard!

Breaking News, 22/11: Soon the french Guidelines HIV 2016 and the counter report will be published; we will keep you posted, here ...


AIDS: Can treatment be reduced?


Richard Cross is a well-known singing teacher on television. But in recent years, this seropositive activist also tries to attract attention on another method of treatment.

Unlike most patients, he no longer takes his daily treatment ...

"I take the medication just twice a week because the load by these drugs in the blood easily exceeds one week. When I take it on Monday and Tuesday, the effect of the drug will last until the week after and keep HIV at an undetectable level, so I have no interest in continuing to take medicines for five days, that are useless, it's an unnecessary over-medication," he explains.

The only requirement for Richard Cross is to have more frequent blood tests to monitor his viral load.

My comment: compared to the 1/7, isn't the 2/7 often an over-medication too? Once good efficiency is made certain (over 2-3 years ...), are bi-monthly VLs not an unnecessary over-medicalization?

Four days of treatment instead of seven


Richard has started this therapeutic alternative alone, to reduce side effects by antiretrovirals; despite the evolution of triple therapies, in recent years, their long-term impact remains uncertain.

Today, scientific studies are far from validating a medication two days a week. The latest, the ANRS-4D pilot study, evaluates the efficacy of triple therapy, taken four days a week.

"The 4D study consisted in giving reduced treatment to therapeutically successful people with an undetectable viral load at baseline, a reduced treatment where triple therapy was given four days a week," says Dr. Pierre de Truchis, an infectious disease specialist. Result: after one year, the researchers found a significant success of this reduced treatment strategy because "for the hundred patients who started with an undetectable viral load at the beginning, 96 of them kept their viral load undetectable, throughout the study for one year ".

My comment: De Truchis himself concluded that the 4 failures are due to cowardice, cheating and sabotage: will he finally take note of his own corrections?

But it is still too early to recommend this approach to patients. Especially since it requires strict medical supervision otherwise this reduction of drugs can prove dangerous as confirmed by Dr. de Truchis: "Many patients come to consult and have made of themselves a reduction by their own accord. In this case, there is a risk of resistant viruses ".

My comment: The infantilising discourse of de Truchis is probably false: he has never brought the slightest beginning of evidence. At the end, such evidence could be demanded!

My comment: strict medical supervision is a lunacy, a pro-domo, corporatist, castrating injunction, without the slightest factual justification: the initial, once and for all, determination of Premium Eligibility is enough. Viral load monitoring, more frequent at first, is desirable without being essential. What then about strict medical supervision? Pffff ...

Therapeutic and financial relief



To confirm this strategy, it is now necessary to produce a new double-blind trial that includes 700 patients.

"We will compare a group of patients who take the treatment all week with the one who takes the treatment four days, hence the name of 4D. And we will try to show that taking the four day treatment is as effective as taking it daily. This strategy is visible in France, patients wait for it, but it is absolutely not visible at the international level. Americans look at us with a lot of skepticism and for this reason we need to have extremely robust results "explains Professor Jean-François Delfraissy, infectiologist.

Finally, the last argument advanced by the proponents of this new therapeutic approach: the potential savings generated by a lower consumption of antiretrovirals.

My comment: R. cross had slipped an affectionate wink to J. Leibowitch, the inventor. The report could have mentioned the years of pharmaceutical remission thus obtained (more than 800 to date) and the enormous hope of being able to treat more patients, to tackle the million of deaths annually, especially with children.


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

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