112

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



Are there many PTCs?

By Charles-Edouard!

Well, another false testimony...

What test? Specify... The false testimony is often: I have a friend of a friend who has tried lightening... I've broken it down here: True and False Testimonials. One mistake is to lump all lightening together. Just as there is not THE vaccination but Vaccinations (some work, some don't), there is not THE alleviation but ALLEGATIONS. Forget Mono-IP (mediocre and obsolete) or TRULIGHT (to be avoided), it's rubbish. Fortunately ICCARRE (and also Mono-DTG) works very well, even excellently.

Let's take a patient, rather allergic, with multiple resistances, happy on Eviplera®. Happy yes, but for how long? When the slow, pernicious renal toxicity sets in, then, for real, he has no nice options left. Another patient, with the same profile, has started to lighten Eviplera, progressively, step by step, she is at 3/7... She postpones the renal toxicity as much: Who wants to travel far spares his mount! So you have to ask yourself questions BEFOREhand. With a good doctor: I published a list

Let's go back to the PTCs: are they numerous?

We saw in the previous post what PTCs (Post-Treatment Controllers) are: they treat, interrupt for good, the virus rises and then falls back to a very very low set-point, undetectable. Are they cured? No, it only lasts for a while, 3 years on average. The situation of the Elite controllers is rather enviable, therefore, that of the PTCs too. If the proportion of PTCs was 100%, we would be saved; if, on the contrary, it is 0%, then it is big-Pharma that is saved. That's why we never tell you about it.

The hospital of Antwerp has identified 4 PTC among its 124 exploitable patient cases: 3%.
In the CHAMP cohort it is estimated at 3%. We have the same estimate (3%) by 2 different methods: let's keep this 3%. From a medical point of view stricto sensu, these people no longer need treatment.

Many useless tritherapies

So, we have a lot of people on AIE (Abusive Extension of Indication), about 25% (?), for whom the START trial shows that there is no clinical benefit, and for whom the only benefit is to become non-contaminated.
We have 3% who could do without treatment after having taken a treatment (of induction, of what? we will see that...), and 0.5% of Elite controllers who will be put, and maintained unnecessarily, under treatment, ad vitam.

When these patients realize this, they grumble, which is normal. Dr Hocqueloux presented the state of play in the Viscontis cohort (see poster, summary). It was the occasion to remind that the Visconti cohort is post-hoc (i.e. made up of patients, early treated, controlling the virus) but that we do not manage to obtain the PTC in the cohorts of very early treated patients. Based on his fragmented observations, Dr. Hocqueloux concludes: you have to treat them early, very early, and for a long time (to hope for TPC). But where does he get this from? Where is the proof??? In France, we have cohorts of early-treated patients, so go ahead, guys, show us that you have more than 3% of PTCs. The lack of clinical benefit of treating early, too early, is explained by Dr Ananworanich Favorable clinical phenotype achieved in less than half of those treated for acute HIV infection (see slides, abstract).

So, in summary, there are poor young people who are bored with treatments, with the promise of a possible post-treatment control, which has never been shown again(SPARTAC trial and even PRIMO cohort). In ordinary chronic patients, we have 3% of PTCs and in early treated patients, who have not developed any embryonic immune response: 0%. Hocqueloux can rant on and on, the problem is there: there is no statistical or clinical benefit for the patient to treat too early.

How to condition to get more PTCs

We find more PTCs in chronic patients than in PRIMO: it is not the fact of treating in Primo that is favorable, so... it is something else... That's what we need to focus on. And here, the new Eclipse Equation sheds light on this: if we improve the EpiGeneDist and/or Immune Response factors, we increase the Eclipse. One AND/OR the other.

The observation of the A5068 trial is that we can hope to increase the rate of PTCs from 3 to 15% (or even more...), by introducing time interruptions, of modest duration (1 month) repeatedly. This is more interesting to develop than this poor Hocqueloux who is watching the cows go by, without making any progress.

Are you a PTC who doesn't know it?

To find out, and in the absence of a predictive tool, the only way is to stop and look long enough at what is happening. If you are in the LOTTI test range, it's all good: if you are a PTC, you have won the prize, if you are not, you have, at least, benefited from the LOTTI interruption (very favorable procedure). If you are in the SMART bracket, let others do it, there are better things to do: ICCARRE

Or you have a clinician who is able to do a viral expansion test in blood bags: method proposed by Van Gulck (Antwerp). If the virus has difficulties to grow in the blood bag, while it only needs a few days in vitro(in vivo it takes a few weeks...), then maybe...

The real question is: are there methods to either increase the Eclipse or to increase the number of PTCs. The Shock-and-Kill will have disappointed: 3 methods are still in the running: vacation cycles (Ragon), DTG cycles (Wainberg), Short Cycles (Leibowitch)

PTCs, Eclipse, ICCARRE and DTG

Increasing the Eclipse is not the same as increasing the number of PTCS. These are 2 different objectives, and in my personal opinion, the search for a benefit for the patient makes it more important to use ICCARRE (1/7, Leibowitch) than Ragon (PTC, Bruce Walker). This is still interesting: because one can consider combining the methods: a TRI-protocol.

We will soon see the avenues open to us...

The universal French genius

Here is a rare intervention(youtube) of Pr Schinazi. Shina-Quoi? Yes, this is the occasion to remind you that he is the inventor of 3TC, F-3TC (which almost everyone uses) and ... Sofosbuvir (which cures you of HCV in a jiffy). His Wikipedia entry. Millions of lives saved, that deserves a tribute. Especially since his speech is rich. He reminds us: 'doing nothing has consequences'.

And to remind our brilliant ANRS, SFLS, CNS, and so on that there is no French molecule... Zero, Nada... That should make you a little more humble. No?

Link

Feel free to comment, like, share and use

97% of patients overmedicated, 22 million without treatment... Let's stop this scandal!