114

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



Misconceptions 2018

By Charles-Edouard!

Hello Charles,

I see your testimonial where you say you blew your copy counter and lost 500 CD4s. Quite surprising, how do you explain it?

It was a trial with DTG 150 mg, 1 day out of 7: the rest in a future post... Don't worry... I became undetectable again quickly and my CD4 came back to 950 immediately (after a step at 700)
In my case, the CD4 count is yo-yoing: sometimes I lose (or gain) 300-400 CD4 even in stable periods, while keeping a rather stable percentage... The blood counting machine does not count CD4, no... It counts the lymphocytes and determines the percentage, then it simply multiplies it. When you are in the high percentages, the slightest fluctuation in the total number of lymphocytes, arithmetically, causes a big fluctuation in the count. One day I will do a paper on the subject: the fluctuation is natural, and it is the absence of fluctuation that is not...

Misconceptions 2018

Whether writing The Book or preparing for our conferences, I find that I have to fight a bit of the same ideas that are at the root of excessive and unnecessary over-medication. These ideas, promoted by a corrupt system, end up being an obstacle to research and to a better quality of life. Just like the list of doctors or drugs, I want to make a list, to comment it and to see what changes from year to year...

The opportunity is given to me by the appearance on youtube of such an attempt to drown the judgment of the patients in an endless, useless and especially... false logorrhea.

Of course, there is no lack of misconceptions around the world: religion, homeopathy, integrative medicine, Keynesianism, the European 'nation', creationism, cholesterol, etc. It is even fun to dissect them. It is even fun to dissect, with precision, in order not to be accused of conspiracy or arrogance, which are the tricks liars use when they are pushed to their limits...

How to spot a misconception in modern medicine

All this junk is not medical in the noble sense and is treated as risk management, something people do on a daily basis, sometimes like Mr Jourdain, without knowing it.

Philosophers have developed Logic to serve as a tool. Now, we must be open to other tools. For the most banal deceptions, Atlantis, the black cat, etc., follow Michael Shremer who reviews the bullshit detection kit. In modern medicine, we have a wonderful tool: the contingency table, well explained at the beginning of this video.

In all circumstances, ask for the confusion table (see Wikipedia)

List of misconceptions

Here is a list of common ideas that we will see how (or if) they are invalidated:
Pharmacokinetics, Total Proviral DNA, Abusive Indication Extension, Achilles Heel, Bombology, Honesty of Scientists, that will be plenty for today...

Chance, you can go and watch this ultimate of stipendiated deception that is HIVonAir, and I even recommend this episode Is it possible to eradicate HIV from the body of an infected individual? by Dr Laurent Hocqueloux , Dr Anne-Geneviève Marcelin , Dr Gilles Peytavin , Pr Gilles Pialoux

Here we see Pharmacokinetics (Dr Gilles Peytavin) and Virology (tanks, Dr Anne-Geneviève Marcelin) summoned to the debate on the question of remission, displaying their knowledge, without advancing things one iota!

What is (total) remission? It is an eclipse that does not close! So any discussion about remission is a discussion about the closing of the Eclipse(its opening, at CV < 50, is a given, it opens every time)

Pharmacokinetics: it's pathetic

Pharmacokinetics is a useful science, when invoked properly! Since the Eclipse lasts on average 14-21 days, starts with a 1-2 day pharmacokinetic extinction phase, explain to me how pharmacokinetics has a role to play in the end of the eclipse? It's impossible because, from the middle of the Eclipse, there is nothing left! And if someone insists, insist on a confusion table where PK is able to predict anything about the end of the Eclipse: This is the public challenge to Gilles Peytavin: show, by a confusion table, that PK is involved in the end of the pharmacodynamic window (the Eclipse).

And if you can't do it, please go back to your studies and don't bother the debate anymore: it' s pathetic.

We don't care whether a viremia leaks into the sperm a little, a very little or a very little: this is the strength of the Swiss statement, clinically confirmedto affirm the non-infectivity, notwithstanding the possible presence of viremia in the semenso we don't care. And it has nothing to do with the closing of the Eclipse! Goodbye Berthe!

Proviral DNA: off the track

Rouzioux has been pumping the air for more than a decade to make us believe that proviral DNA is predictive of anything. She recently added another layer here: this marker is easy to use, precise, specific, practical, robust and reproducible. Let's comment: easy to use(yes, so what?), accurate(oh really? +/- 1 log , is that accurate?), specific(of what? with more than 95% of Junk, unable to replicate, it is specific of what?), practical(yes, so what? practical if it doesn't bring anything, what's the point?), robust(well, come on! prove it!) and reproducible(yes... it's also a characteristic of systematic errors to be reproducible). A good measurement must be accurate, faithful and sensitive: but this thing has no sensitivity! You might as well weigh a coin with a weighbridge!

This is what Anne-Geneviève Marcelin demonstrates with her onion diagram, which must be read with a Log scale in your head

By the way, ask for the confusion table: in ICCARRE 1/7, ANRS-4D, SEARCH 019 it is impossible to establish! To be a predictor of failure in short or ultra short cycles, there would have to be failures! Oh yes, it is a poor predictor in an equally poor alleviation: the Mono-IP. How does Mono-IP contribute to the remission effort?

This is the public challenge to Anne-Geneviève Marcelin: show, by a confusion table, that the total proviral DNA measurement anticipates the end of the pharmacodynamic window (the Eclipse). And, if not, go back to your studies, without stuffing us any more. Thank you very much...

Well... You remember the famous 'Rouzioux criteria': not one of them has withstood ANRS-4D: laminated. So, we hope not to see it again on our screens!

the Abusive Indication Extension: inexcusable torture

The U=U is a valid argument to present to the patient who is reluctant to enter treatment, in the absence of even mild immunosuppression (CD4 > 350). And if this is not a concern, it is criminal to impose a treatment without demonstrated benefit.

The START trial, where all the excess morbidity occurs in the countries of the South, whose sanitary conditions have no comparison with those of the North(go and catch tuberculosis in Sweden or a fatal salmonellosis in France, it's ridiculous!), demonstrates, contrary to the vulgate, that the over-risk in the North is null: indeed the over-risk is exactly proportional to the real over-risk in the South (TREMPANO) and the null over-risk in the North(HIV-CAUSAL)

Here again ask for the confusion table! That of the North, of course! The risk in our over-aseptised countries is out of all proportion to that in Zimbabwe(who would be stupid enough to believe it?).

You are promised a better immune restoration to enter the treatment (too) early: here too, demand the confusion table! Yes, the confusion table! Because no one ever gives it! And for good reason!

The Achilles heel: a concept to be invalidated

The Achilles' heel(I named it that) is a weakness in DTG induced by the previous use of RAL or EVG. This risk factor is amply confirmed (BMM+P cohort) and even confirmed(sic), a little late, it is true, by the authors of DOMONO!(resic). So it is not a false idea! But it is a not very specific predictor. Sensitive, but not very specific. It is a predictor that can be read in the patient's file. Yes, it is. But the virus doesn't have a periscope to read, over the virologist's shoulder, what is in the file! It only knows how to 'read' DNA. The day we will also be able to read and predict, with more specificity, that day, the Achilles' heel will be obsolete. Until then, it remains the best we have! But you still have to take the trouble to read the file... Hein Hoqueloux, you've been fooled on this one...

Bombology: we just have an embryo

When the Eclipse closes, it is the end of the mini-remission. It closes around 14-21 days. , on average. For some 7 days, 30 days for others. Therefore, at 1/7, we are in no-failure mode, and who cares about having a predictor? At 1/7 we are in the white zone, the comfort zone. As the search for dynamic remission is a Darwinian process, when the patient's rhythm changes from 1/7 to 1/10, 1/15, etc., we will eventually enter the grey zone. And there, looking for a predictor makes sense.
Well... At 1/7, pharmacokinetics is in the toilet... I get it... Measuring the reservoir has a very small chance, very small unless you use another method than proviral DNA, as easy as useless... Achilles? We don't really care... Mono-DTG for 1/15??? I don't feel it... But well, the proposal exists, so we'll see. There is still the 'Science of Bombs': in Choke-and-Mute, we vitrify the system with a mega-bomb, and then we take advantage of the Eclipse. How to build a mega-bomb? A weak bi (DTG/3TC) a concrete bi(DTG/XXX, I'll come back to that soon), an unexpected TRI (NVP/DTG/X), the patented Quadri, the Dodecatherapy(I'll come back to that soon)? There is bound to be something that is better than another. In any case, Isentress®, we don't feel it... Kaletra® ??? It's not a done deal!

So for the moment Bombology, the 'Science' of the best synergies, is a bit of alchemy. We are already lucky that the Leibo patent works, but if we no longer have Videx® or if we are allergic to Abacavir, we have to find something else!

So Bombology is a technique to be developed, we need people, ideas, money and volunteers(in large numbers), we will get there. And then, one day, someone will come up with a concept that will invalidate this trial and error research.
So, it's not a bad idea, but we'll have to do it right...

I forgot about Septism: what was I thinking???

It's true that with the announced success of Quatuor, we just forgot that this nonsense had also made its time. We will develop in 2019...

The honesty of scientists? In this mercantile era ???

Here again, if you are not already disillusioned, watch again HivOnAir® or the Rouzioux video! It's so distressing that you could cry. Everyone has their own little ditty, the one they know, the one they get paid for. Look at how Peytavin embarrasses even his own colleagues in this golden galley! He can only tell you about what he knows. But is it relevant to the case? No! Then it's talk for nothing. The mistake is not Peytavin, as a person, the problem is to summon him to a debate where he has not contributed anything. But this choice is not trivial: it is motivated.

So, to see the patients, in suffering, being bamboozled in this way, yes, it is sad... The honesty of scientists? A misconception!!!

In the news

- U.S.: 72,000 people died of overdoses in 2017, a record. It's the opioid crisis... And who is it that put this on the market? And who's the one who authorized it? And who is it that prescribed them? You criminals!

- Oh, this is not recent, but the subject is fascinating: When Snails Attack: The Epic Discovery Of An Ecological Phenomenon

The French genius

The genius of the week is Charles-Edouard! You are never better served than by yourself... Honestly, I had a great time watching this conference at Pasteur!
It is now available on YouTube. That's it! We know how to do it too!

Video in 3 pieces:
Part 1
Part 2
Part 3
And the: Verbatim

Otherwise, have a nice time with the choristers, on video: a treat...

Don't hesitate to comment, like, share and use

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