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



By Charles-Edouard!

From a user of Kivexa/ Viramune (NVP/ABC/3TC):

Viramune is among Leibowitch's favorites. A priori we can do 4/7, since Leibo has published it in ICCARRE and the APHP has even taken out a patent. On this basis, we can go up to 2/7 or even 1/7. It would be a shame to change it. The 1/7 has been published very officiallyby Pr. Ch. Peronne, head of the infectious diseases department (the highest 'rank') and Vice-President of the Technical Committee on Vaccinations. More Kosher than that you can't do... But, well... If nobody talks about it, the patient, kept in ignorance, misses it. Too bad...

What is a PTC (Post-Treatment-Controller)?

Everyone knows the Visconti: those patients who were treated early, too much (too much?) and who, after an average of 7 years, stopped the treatment and found that the virus did not return. Asier Saez-Cirion (Pasteur Institute) published an article that made a lot of noise.

We are talking about control over very long periods, not just 3-4-5 months as is often found in Eclipse measurements. The Toronto patient (3-4 months of control) or those of Boston (9 months) are not part of this.

In France, we found these controllers in people treated early. It was concluded a bit quickly(as soon as you see the name Rouzioux, you know there is a wolf) that only early-treated patients can claim this status. We shall see below that this is not the case... Let's just remember that a PTC is a patient who controls her virus, in the long term, following a treatment and its interruption.

Are PTCs unknowing Elite Controllers?

With the AIE (Abusive Extension of Indication), patients who could hope to control their condition are put under indiscriminate, interminable treatment, without consideration of the health environment or the clinical picture. If the treatment is withdrawn, and it was useless, it will show... There, the patient is going to give the doctor(s) a hard time, that's for sure!

That's about 0.5% of the treated population. Rare, but good...

We know a little about the characteristics of these Elite controllers (who are doing very well, without treatment, thank you for them, leave them alone, you thugs!). Asier Saez-Cirion is studying these Viscontis and believes that they are not crypto-controllers-d-Elite, they don't have the profile. So don't confuse: CEs and PTCs should be counted separately...

PTCs: who are they?

The mistake would be to believe that there are ONLY the Viscontis. In fact, there are (many?) others! But to find them, you have to interrupt the treatment, and look for a long time, because the control is not instantaneous: the viral load increases at the interruption and then goes down to a new very low set-point, even < 50. Jon Barnett, author of a 'disappeared' blog, had controlled (well...) after several months (so he didn't understand anything anymore...)

PTCs are not a priori controllers, but rather following their treatment AND its interruption.

So how do you find them? Well, by chance or by looking for them!

Randomized trials of 'therapeutic vaccination'. Volunteers are 'vaccinated', either with a vaccine or a ... placebo... And we ask everyone to stop the treatment, and we look on the long term, to see if the vaccine helps to regain control. There, Oh surprise, we find 'durable controllers'!!! Bingo for the vaccine ??? Well no... They were found in the placebo group... The 'vaccine', in fact, does not work at all!

We will read: The CHAMP Cohort: Post Treatment Controllers Identified from 9 Clinical Studies: it's the topic of the moment!

Another rarity: Antwerp clinicians have found patients who have been lost to time. In Paris, you don't come to the hospital anymore, you're safe, no one comes after you... These patients are renegadesIf they do not take the treatment, they stop it on their own, do not get worse, and probably do not even know that they are in control without treatment (essential before). We see that the CV is zero. And they have a hospital record to shed light on their previous clinical picture! This is not a Belgian joke... A Belgian joke gets around, but this is total radio silence. They talk about the 'Boston patients', who in fact won't control anything, and they hide the Antwerp patients under the pharma-media carpet. Ellen Van Gulck has published: Control of viral replication after HAART discontinuationand a full description here.

PTC: How many are there? Are you? TPC and ICCARRE? TPC and DTG?

Ooh... la la ... That's all for today. Obviously the subject is fascinating. There are many things to look at under a new eye, and it will be for another time ...

Judiciarization

- Levothyrox: 42 patients sue the Merck laboratory.

- Shortage of essential drugs: the Senate and the Academy of Pharmacy sound the alarm. Considering my stock, this is not likely to happen to me... Patients on Videx (BMS) are in trouble, nobody talks about it!

In the news

- Towards a universal hepatitis C testing in France. Well... Yes... There is no point in burying our heads in the sand, especially since the more we treat, the richer Gilead gets. That alone is a good reason; in fact THE real reason?

- Test DODO : 1/2 strategy with Atripla® and also good news from the A-TRI-WEEK trial (also a 1/2...) : because we tell you!
Maintenance at 3 days per week with a single EFV / F-3TC / TDF tablet is effective and decreases subclinical toxicity. That, Gallant, he never talks about it... never... The others ... either...

- Even Alexandra Calmy goes Mono-DTG! Stable HIV-1 reservoirs on dolutegravir maintenance monotherapy: the MONODO study.

The French genius

Splendid, touching, energetic and still subtle. I love to succumb to the carnal power of the interpreter the interpretation! (youtube) Ah, French music!

Note: The prototype of the 'Choke-and-Mute' presentation (Pasteur on 17/05/18) is available, and soon on youtube

Of course, we will watch the France-Croatia game.

Do not hesitate to commentand share and use

good weekend, good stuffing and not too many drugs ... Right?