This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.
Reservoir measurements-2
Reservoir size: # 2 Analytical Interruption
By Charles Edouard!
The analytical interruption measures the reservoir very accurately. I myself work on it with VL every 2 days ... If I had been treated early, I would have hoped that VL does not come back (... Visconti), but as this was not the case, this will be just to know what day it comes back. I already know that I can go for a week without medication since I do Hypodolu (1/7 in mono Tivicay®) for more than 6 months.
Why analytical interruption?
I recommend reading my earlier post: I describe DNA method reservoir measurement
This measurement has been of no practical use to me. In a cohort, it may be interesting to follow the trend, for example:
- Among early-treated (and Visconti ...), we thus can see the reservoir going down faster, on average.
- In the ICCARRE trial it has been thus confirmed that reservoir is not otherwise affected
- In BIOSANTECH vaccine trial, a significant improvement can be seen.
Individually, no practical information can be drawn from this indicative measurement. On the contrary, measurement of time-to-rebound is very rewarding: it helps know, without risk, when the virus bounces back above detectability threshold. This is useful for:
- Checking BEFORE ICCARRE, if one is a good candidate
- Once in ICCARRE, whether it is borderline or if there is more room
The analytical interruption is different from therapeutic interruption (aka drug holidays). In analytical interruption, Viral Load is monitored frequently and treatment is resumed as soon as the virus shows its face. It therefore leaves the virus no chance to replicate and resume its undermining. This provides a personal and useful data: it can be used to calibrate the ICCARRE reduction.
For most, the time-to-rebound is 10-15 days, making the weekly dosing possible.
Time to rebound at the Hospital
At the hospital, it's simple. You follow the protocol: you stop treatment, and then you show up for a blood test every 2 days. That's all ... As soon as the virus shows back, you resume your same treatment pronto. This method is laborious, is used repeatedly in the reservoir reductions trials and other research. We know that there is not the slightest risk. The resuppression with the same treatment is achieved every time: no exception. At the hospital, it's simple ... But they will probably not offer it to you!
Time to rebound in City without prescription
It's possible! Time to be smart ... You have to anticipate that it may require as many as 5, 10, 20 blood samples.
It's possible, I did it: it's possible...
That's for one VL ... One must be smart, but again, this is explained in this guide... Your turn.
You're getting there? This is nothing unusual, since I did it.
There, there is a catch: you'll be able to do ONE time, but when you go back two days later, the secretary will see you just did one. Shit! Your plan has been uncovered.
But I managed to do it ... So can you
ICCARRE gave me the idea. Indeed, when you follow ICCARRE 1/7, it is well known that the time to rebound is greater than a week, so it is unnecessary to test the first week! So we will test the second week...
Salami Slicing
We are going to working week by week, and in each week: Monday-Wednesday-Friday
You do the first week. Validated or not, the virus comes back or not. Then you resume treatment, say 3-4 weeks. Looking at your results, if the virus has picked up on the third day, then, so be it ... It ends there. If the virus has not returned for the first week, we will make a longer interruption and NOT measure the first week: we will measure only the second week.
Treatment is then interrupted (you take no treatment) and no further action during the first week: we will measure Monday, Wednesday, Friday of the Second week, and at the end of the second week (or earlier if necessary) treatment is resumed (say 3-4 weeks). And repeat...
We slice it, week by week, and reduce the problem: we just need to find a solution to have blood draws Monday, Wednesday and Friday.
We do 3 VL in a single week.
By sequencing smartly, we thus arrive, step by step, iteratively to 7, 14, 21, 30 days...
It's a bit long, but we have already simplified the problem to how to do it Monday, Wednesday and Friday.
Vagrancy
There is quite easy: Just go to three different laboratories!
I have successfully used three Parisian labs (belonging to different groups), with results on the web!
This is the basic principle ... In a future post, we will see what to expect and results!
Good Night and Good Fuck!
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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