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Friday, November 17, 2017


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

The amazing and promising 1/2

By Charles-Edouard!

In comments, a Genvoya® not innocent at all!

This example shows how younger people are wrong not to worry about long-term toxicity, in advance. With age comes also polypharmacy (eg statins, useless but often prescribed). Now, Genvoya® has a non-exclusive booster: it is included and boosts one of our other drugs and thus we are in overdose. This also highlights a low noise, sub-clinical, but very real, toxicity.

1/2 = half-dose or 1 day out of 2?

1/2 comes from community practice, not academic. It results from a pharmacokinetic vision, complementary to the Eclipse. Many do not understand Eclipse.

So be it... The 1/2 does not lead to remission. On the other hand, it is understandable by the Septists, that is to say 99.999% of doctors and patients. Pharmacokinetics at heart, they practice it with permissive drugs (eg Triumeq®, Atripla®). And with long lifetimes, taking 1/2 pill each day or 1 pill every 2 days is quite similar; The 1/2 is a dosage adjustment. This is the A-TRI-WEEK trial, which worked very well!

I have done Mono-DTG: 1/4 of a pill (mini-Dolu), others are doing Mono-DTG 1/2 of a pill (or even Mono-IP 1/2 dose). Certainly, my preference remains for the short cycle. I liked reduced dosage also!

Efavirenz 300 mg? Why not?

DMP-266-005 Joel Gallant Hill Ananworanich Calmy Efavirenz dose reduction
In the Phase II trial (DMP-266-005, by Joel Gallant et al., Never published ...), 200 mg works better than 400 mg and 600 mg ... And what do they chose? Well ... They didn't care ... 600 mg and fuck you all! Dosage is the responsibility of doctors, not of the pharmaceutical industry ... Facing a suicide epidemic, smart people tried EFV 400 mg: it works. For some unknown reason no one tried EFV 200 mg ...Go figure ...

At the IAS 2017 conference (video here), at minute 49:25, Pr Kiat Ruxrungtham, says: we do with 300 mg and it works very well... Here is a good idea! 300 mg !!!

Note, incidentally, in this sequence, something interesting: they have done tests and offered to patients who have CNS problems with EFV 600 mg to reduce down to 400 mg without even a dosage. And it works ... Which leads him to say, in the same wake, that it also works at 300 mg. Question: If it works without problem at 300 mg, why restrict oneself to patients complaining of CNS problems only?

What synergy???

Phase II data is available here: Dose Optimisation: A Strategy to Improve Tolerability and Lower Antiretroviral Drug Prices, by Hill, Ananworanich, and ... Calmy! (Sic)

Synergy, a heuristic concept, with no identified mechanism, claims that some combinations work better than others. However, the dosage is never reconsidered. Thus, 3TC is set at 300 mg from its early introduction. It dates back to AZT / 3TC Bi-Therapies. Nobody ever had a commense reflection: well, with Efavirenz, maybe we can reduce 3TC a bit. As If ... There are some clever people, who have seen that Cobicistat (an hepatic metabolism inhibitor, often named: EVG booster) ALSO boosts TDF, and ask the question why do not we reduce the amount of TDF at the same time? Simple, doing so it brings not profit to Gilead.

There you go: Effect of cobicistat on TDF: what is true for TAF may also be true for TDF

Especially since they will effectively reduce when switching to TAF. And may be, they already have a me-too copy of 3TC (I bet you they will add another Fluor), some sort of 2F-3TC, that they will come out of their magic hat and market as an all new combo, less dosed.

And no one to look back and say, "Oh, but we used 3TC abusively, at 300 mg, for years without asking any questions."

300 mg EFV + 150 TDF + 100 F-3TC: a poor man's Caviar

Kiat Ruxrungtham Efavirenz IAS 2017 dose reduction
It is clear that, today, patients are very well treated in Thailand, probably better than at home! Intelligence is not reserved for us. So Siamese or Chinese clinicians will uncover the hidden Gral: they are at work there, without you noticing. Then will appear a combo composed of 300 mg EFV + 150 TDF + 100 F-3TC (or 150 3TC), to take twice daily for 1 year, followed by 1 per day ad-vitam. Maybe even 200 mg EFV ... Why not?

And we can only then note, once again, the inanity of the ANRS. We have no ideas, they say. Yet, alternative proposals are moving forward.

You will be fattened with injectables at 10,000 Euros per year, whereas they will have nice and effective treatments at 50 Eu / year. That is crazy! After we are being told that French workers are not profitable, they are lazy! So they cut jobs, cut jobs, cut jobs ...

No need to go to Thailand: sooner than never, Greeks, Ukrainians, Cubans, Venezuelans will get at it.

In the news ...

Does Prep flops? Only 5,000 Prep users! Activists are highly disappointed! So they go at it again ...

Interesting article by Carole Petit: puI'll publish a translation real soon!

Universal, mandatory vaccination is voted: when will come mandatory treatment? Not before the arrival of injectables... So this is coming. Here again subsidized Seronegative activists will be at work!

Feel free to comment, to like to share and to use

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

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