Exclusive

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

I pruned a bit (sorry ...), but this is the spirit:


If you think you or your doctor know how to talk to the virus, you live in delusion: The virus is deaf. Yet, with a good molecule (finally !...) and a good method, it is 'defeated'. The method is conceived from the accumulated evidence and those coming. Opinions, feelings that ignore the evidence are superstition! Don't be afraid ...!

The first line with Tivicay® monotherapy: Exclusive news

This post follows our post on "Tivicay ® monotherapy as induction", where I announced what was foreseeable: Tivicay ® monotherapy as first treatment.

Do not confuse these monotherapy results with maintenance monotherapy (clinical trial: DOMONO) which results are expected late 2016: Congress on HIV Therapy (Glasgow 2016), because of delays in recruitment.

Since the induction monotherapy is for treatment-naïve patients, they do not have the Achille's heel. And all those, who do not have the Achille's heel, are in fact naïve to first generation INSTIs (Isentress® or Stribild® / Genvoya®).

The results are published: this is therefore not, strictly speaking, an exclusive. But since no one has noticed this crucial information, well ... yes ... You hear about it for the first time, here.

Just as you had never heard of Achilles or WHO's approval of Efavirenz 400 mg, it is time to ask yourself some questions about your favorite media!

Lanzafame: the frontrunner!

Dott. Massimiliano Lanzafame?? He is no stranger to us. He appears in this post: "WHO proves us right !". He is to Italy what Leibowitch is to France. His method is a little different, though: he reduces a dose, without any pre-requisite on reservoir, CD4 count, etc. (these prerequisite belong to the 'Parisian', subsidized, bullshit), and demonstrates that efavirenz reduced to 400mg, or nevirapine, reduced to 200 mg, just works as well. No other prerequisite than having undetectable Viral Load for 1 year. Same with Protease Inhibitors.

This is less ambitious than Dr. Leibowitch but Dr. Lanzafame has managed a get his recipe, albeit modest, throught the yoke of international trials and reach, without any reservation, its approval by the WHO. Neither Leibowitch (with his wonderful ICCARRE) nor Katlama (with her shaddy PI monotherapy) ever got even close.

He works in a small hospital (Verona ... That's no New York), so has only few patients: he has good insights, good methods, just a smaller army ! Who cares ? ... Besides we love his way of asking, falsely naively, questions that are of prime importance: If maintenance works with a half dose, then, what use are those famed blood dosage for ? What is it? If not pure bullshit ... I just love it!

Of course, among the small, Peytavin-fed, Parisian clique, he is not popular. But with patients, this working very well. And, let's add, the validation of his Efavirenz 400mg by the WHO (following the ENCORE-1 trial), is really a major success!

So, off he goes, as we did here, with the results of the clinical trial ING 111521, which I commented here.

This trial showed that 90% of patients reach the 400 copies beacon (the final leg to undetectability) in less than 10 days!

Then he will repeat the ING 111521 trial (which dates back to 2008! ...), but, without interrupting at day 10. Same as ING 111521, he goes with 9 patients. The trial ING 111521 protocol required to stop the mono-therapy at day 10 : this time he just goes as far as undetectability... and, obviously, if the VL becomes undetectable, he carries on. There is no reason to stop.

A bit like Dr. Lafeuillade, whose patient by himself, in first line, in primary infection, started with mono Tivicay ® ... and it worked, so why change his regimen.

In my humble opinion, he scored earlier than Salpetriere (a Parisian Hospital)... Blame it on Voltaire, if you want: they'd better move their ass a little faster.

So, our Lanzafame started with 9 patients for first line Tivicay ® monotherapy.

This is far from well greased, slow collusion of our North American clinicians. But where are those Canadians, who had pinpointed the great surprise of the test ING 111521 first ? Not to mention, of course, Dolutegravir's inventors. Here, it is easier to understand: it's a big business. But Canadians? Disqualified, despite having had the pole position?

There you go. It is published here:
http://www.ncbi.nlm.nih.gov/pubmed/27097366
Dolutegravir Monotherapy in HIV-Infected Patients With Naive <100,000 copies / mL HIV RNA Load. It's from Lanzafame (so it's good ... see his résumé); this is with 9 patients, and I will publish the results in a coming post: it's great!

Say, there are only two questions to ask oneself:

1 - is Tivicay ® monotherapy possible, and if so... 2 - for maintenance, is 10 mg as good as 50 mg?

Soon there will be only one left: the second ...

Next posts: Why avoid the TruLight trial, how to wean antidepressants, Yes, This is Achille's !, best doctors ...

Good Weekend 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.