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Saturday, December 23, 2017

true and false testimonials

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

True and FALSE testimonials

By Charles-Edouard!

False testimonies have poisoned the debate. They always took the form: "I have the friend of a friend who tried the aleviation (eg 5/7) her viral load exploded, she became multi-resistant and waits for her last hour (sic) ". Or a variant ... Whatever, it was always the same pattern, a nauseating rumor. Of course without the slightest detail on the so-called attempt. Partial and second-hand information.

Dr. Cal Cohen, father of FOTO, predicted:

Obviously, there were rules to be worked out.

They are developed from failures: successes do not teach us how to avoid failures.

Now, these kinds of 'testimonies', which would be useful if they were truthful and educated, have completely disappeared. ANRS-4D has nailed them!

This continuous flow, discouraging and irritating, has not dried up at the announcement of ANRS-4D's results, but at trial launch : the mere announcement of a promising trial, has put an end. That's enough to qualify this continuous and nauseating flow as FALSE testimonials ...

Real testimonies and obvious errors

I analyze, here, 2 credible testimonials, which reinforce the rules, difficult to establish, for lack of failures. They are not made for dogs, and one should take them into consideration: read carefully our Practical Guide 4/7 and Practical Guide Mono-DTG.

Painful Failure, under 5/7, with Stribild®

At the time, I had argued against such a double move: switch for Stribild® (out of Viramune®, on top of that...) and move directly to 5/7. The pillars of the experimental ICCARRE are: efficiency, progressivity, frequent VLs. In addition, Leibowitch was up against INIs. My argument was to be very careful with Stribild®. For short cycle, I'm sceptical! First tests with QUATUOR: results in ... 2020!

I argue, I argue ... One thing will stop me: the famous: "My doctor is OK with it and will help me".

It stops me completely: the patient gets a medical follow-up: I am left silent. This thing with medical monitoring always leaves me skeptical given the quality of the profession, however, the argument silences me.

Let's confront this experiment with our Practical Guide 4/7:

Efficiency Verification: Where is it ??? Before entering short cycle, we make sure that the combo is effective, in 7/7, for several months (ANRS-4D: at least 4, Practical Guide at least 6-12)
Progressivity: where is the 6/7 step ???
Frequent VLs: I think that it was done.

Risks identified after ... We could not know beforehand ... The patient is exposed to the so-called Achille's heel risk (previous use of RAL) and to the Quasimodo trap: the transition from Viramune® (NVP) reduces the dose plasma of DTG but also of EVG.

Classical Risks risk is coveredOK ? comments
Efficacitynot verified    verify over 4-6 months or more
ProgressivityNo     stonestep at 6/7
frequent VLYes   at month 1, 2, 4, 6, etc.
less classical risksrisk is understood? comments
Achille's HeelNo   moreover, EVG is not very powerfull
hunchback trapNo   especially when coming from de NVP
expert follow upNo (?)   go to an expert doctor
results 22.000 copies but, ICCARRE is not at fault

The catastrophe had been announced: it occurs!

Rightly so, you should not believe everything you read about aleviation

Here, the testimony is incomplete and (intentionally?) false

Here is the sequence. Very early (too early?), Dr. Bart Rijnders launches the DOMONO trial: everyone is very excited (too much?) by DOMONO: a trial without specific conditions to inclusion and with a comparator arm: the must-have. At first everything goes well and the news leaks out, which encourages more. While DOMONO has already started, Prof. Katlama announces, in a conference, that he has identified a major risk factor: Achilles' Heel: a clear risk if RAL or EVG has been used in the past. B. Rijnders continues, ignoring it.

Conversely, I warn as best as I can do, especially our witness (sauvenière). It exhausts me, because it is unexpected, difficult to explain, to understand and difficult to admit.

The 'witness', in denial, has an Achilles as big as the nose in the face: he comes from "Viramune® and Isentress®" (Again ...), in long-term success. More Achilles' Heel than that, you die! I insist then falls the (in)famous: "My doctor is OK with it and will help me".

All this is perfectly archived ... Then, Dr. José Blanco, in his presentation at CROI 2017, confirms our analysis. B. Rijnders refuses to revisit the data of his cohort and his protocol: the disaster is no surprise! It was not possible to know at launch of DOMONO, then, it became obvious during its course: the trial is invalid.

Our witness (sauvenière) lies when he says that he was well accompanied (no frequent VLs ...) and had the righrt profile. In fact, he had the worst profile, and he knew it. Victim of his own negligence, he prefers to accuse the strategy, rather than his imprudence: a scenario for Dr. House.

The nauseating medico-pharmaceutical mob will immediately rush into the breach.

Let's confront with our Practical Guide Mono-DTG

identified risksrisque is understood?OK ? comments
Achille's HeelNo    Beware of an history of RAL or EVG use!
Hunchback trapNo     double DTG for a few weeks
frequent VLsNo   Blood draw at month 1, 2, 4, 6
Adheranceyes   in experimental mode , this is important
expert helpNo (?)   choose expert help
Result rebound at 1000 copies but, Mono-DTG, well understood, is not at fault

A Good Practical Guide vs a bad doctor

In both cases, there is poor medical advice. Despite the absence of a Therapeutic Guide, a medicalized ICCARRE deploys in Maghreb, where doctors receive a 'training' full of errors! So, now, there is a risk due to poor medical monitoring. They CLAIM that ICCARRE will be medicalized or will not be WITHOUT quality medical training or Therapeutic Guide, so, we must expect the worst! Patients are more than ever on their own!

In the news

- The new site the Friends of ICCARRE is online! At long last!!!
- An interesting lecture by Dr. Arvieux on Youtube highlights the misallocation of budgetary resources: a very PRO-ICCARRE argument! (partial slides here)

- Dr. Dupagne explains: the discordant doctor is excluded from the scientific debate and becomes non-grata conferences! In Arte-Replay or on his blog

- These killer mini-drones made the buzz

- A choreographer dances for ICCARRE

- a controversy opens (finally!) on the actual contents of the reservoir ... To be continued ...

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

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.

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