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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.



Mono-DTG 1/7 (150mg): failure rectified

By Charles-Edouard!

Question read on Doctissimo, from a thoughtful friend

First there is some confusion... Her friend does 1/2 (discussed here). It's not ICCARRE: as for the questions she's asking, they've been answered in the FAQ of the Practical Guide: yes, you can do ICCARRE after having come out of an AIDS stage, and yes, you can easily catch up in case of failure (rare) while remaining on the same therapy.

Mono-DTG 1/7 (150mg) : failure ...

When you do experimental work, you have to go slowly, step by step, and only stop when you fail (when the level rises above a certain threshold). I don't do things by halves, I change my mind as soon as it goes up, even if it's wrong... So I had some small failures, like my failure at 1/27 (150 or 200, I don't remember)... It had worked well until 1/24... Well... Too bad, I would have liked the 1/30... Anyway... Well... My attempt of Mono-DTG, 150 mg in 1/7 has been blown up... And not only a little! Here we change scale.

Usually, I do my CVs conscientiously every 2 months. Except that here, very rarely, I find myself stuck abroad-not cool: no self-service CV on the horizon. I waited... No luck, just at the crucial moment. Well, as a result of all this, I blew up the counter! First of all I blew up my personal counter, my zenith went full speed towards the North. I was a bit surprised but not too much: my natural defenses have not seen the virus for a long time. Now they are caught off guard. And I really blew up the counter: I have more copies than all the published failures in Mono-DTG combined (BMM+P & Domono, plus all the little tests): I'm doing more than 50% on my own! That's to say that it was a heavyweight!

Well, I'll stop the giggling right now, this case is behind us, and well... So let's stop giggling and silently watch the Master who will show you how he managed all this like a boss, finger-in-ze-nose.

I lost 500 CD4s! So what?

I stop answering to the whiners who squeal when they have lost 50 CD4, it's just rubbish. But 500! That's when you've got to put your man down!

You have to have 500 to lose, that's for sure... With my years of lightening, everything is fine on this side: I usually have around 1000. So even with 500 less, we are far from the (mini) risk zone, which starts below 350, as everyone knows(except for the idiots who think that you can catch tuberculosis, salmonellosis or e-coli in a healthy environment).

This is an opportunity to remember that, for the average patient, when you take the virus out of its pharmacological cooler, you are back to where you started, quite quickly. That's why we don't do experimental racing with a Nadir on the floor... On the other hand, ICCARRE 4/7 can be done, since it is no longer experimental.

And I never miss an opportunity to remind that total proviral DNA is anything but a reliable measure of the reservoir, yet it exists... After all, I was the one who first named dynamic remission, thinking that it is a bit illusory to hope for better, for the moment. So read again Segal's famous article : The problem of HIV persistence despite antiretrovirals(which really annoyed Siliciano... Hi, hi, hi... )

Well, come on... We'll catch up with it, no problemo

Enough whining, let's make up for it... Well... at least between Mono-DTG and the good old combo-Leibo to make the 1/15, there is no photo... So, anyway, we would have gone back to the good old tried and true methods. Even the 1/7, it bores me... And since I'm the one who formalized the Choke-and-Mute, on a Leibo-Sonigo intuition, it would be nice if I were a bit consistent with myself.

We have no tools at hand, no genotype, nothing, nada. We're going to work out a strategy, robust while being blind, so we're going to use our neurons and what we know otherwise.

Which strategy to choose?
Well, we have 3 strategies at hand:
A- make a drowning to start again on a healthy basis
B- re-enter the treatment with:
B1 - DTG
B2 - without DTG

Here is the problem you can think about: what would you do in my place? Go ahead... Pros and cons... Have some fun... You'll find out...

We'll see how we did it and why, next time

In the news: everyone wants to kill the HAS

The medical-pharmaceutical underworld has mastered registration with the FDA and has shaped the EMA into a costly but docile re-registration chamber. useless.

All the more so since, afterwards, it is necessary to go back to the bar: in Germany, in the United Kingdom, etc. And in France(ouch!!). And in France, there is the transparency commission: a revolution, a great achievement. Well... They want to kill him... And Juncker, that crook, sold it to them:

Trump's Verbatim:

According to the Dow Jones, it is align standards on pharmaceutical products ...

On the side of the commission, the question of soybeans is minimized, almost 'anecdotal' according to the commission, but quite strategic for Trump: indeed 95% of American soybeans are GMO and rotten with Glyphosate: how can we ban glyphosate (RoundUp) with one hand and massively import glyphosate soybeans with the other?

The real question is the harmonization of marketing authorizations (and prices... in the minds of Americans...)

Juncker is a crook... Who did he swindle? Trump? By promising him what we can't deliver? Will France stand up to the enormous pressure to make us swallow American crap at a low price?

The Transparency Commission (HAS) has rejected SYMTUZA® and Descovy® by giving them a shitty ASMR... Well... They could have looked at Isentress HD®, but that went under the radar... ASMR in shit... Well ... well, at leastthat's it...

Oh well, no... The obscure transmission belts, exactly what the commission of transparency is used to fight, start to work and here we are with a firework of vitriolic communiqués by the usual bouzigues: TRT-5 and SFLS, all these kindly sponsored people... Pffff... And never a single patient case to highlight, of course...

The HAS emphasizes the existence of alternatives in case of toxicity. One of the arguments of the puppets is to say: 'look at that! It is authorized in Germany, in UK, etc...'.
'France would thus be one of the only two countries in Europe to have this situation', the SFLS notes, amazed.(Oh the beautiful argumentation!). Certainly, but the argument of the HAS is the existence of alternatives to toxicity... And as an alternative of choice, there is relief... And this does not exist in Germany or in England and even less in... USA! Nor... in the SFLS, as you can see...

So, when we no longer have the transparency commission, we will only have the opacity of Washington, and then we will suffer...

Other news: it's back to school!

- Several times we asked the question: can we do better than EFV 400 mg, for example 200 mg? Well, Lanzafame has done it... And he took the opportunity to withdraw TDF (or ABC), that is to say EFV 200 mg + 3TC 300 mg 7/7 with as an alternative NVP 200 mg + 3TC 300 mg. It is here; we will come back to it!

- Moncay's results are in line with all the other trials not taking into account the Achilles heel: it's a disaster... Cata announced by Katlama... Cata inflicted to the patients... Pffff... We would have liked to believe that Hocqueloux was smarter than Raffi. We are disappointed... But Mono-DTG, at Lanzafame, still works well...

- This publication by Molina: Doxycycline prophylaxis for sexually transmitted bacterial infections: promises and dangers. It's a debate... Paris now has a whole school of doctors, once fervent activists of tradi-prevention, who have turned their backs and say of PreP: 'it works like a vaccine, it's miraculous...'. What remains are the other STIs and the need to find an effective and economical prophylaxis for them. We'll come back to that...

- We have listed one more doctor, a long-time alleviator, whom we did not know: Dr. JEAN DEROUINEAU. That's it... Know how to take part in it

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Have a good Week end, Good back to school, good stuffing and not too many meds ... Huh?