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DOMONO: Tivicay Monotherapy

DOMONO: Tivicay (tm) Monotherapy

This paper was originally published here, in French. We provide the google translation for your convenience. Proper translation will come soon. Some practical aspects may differ where you live.

6 comments:

  1. AnonymousJuly 26, 2017

    Hello,
    After a tumultuous course in treatments and aleviation, I am under Tivicay® monotherapy that I am aleviating, I take half a pill four times a week, Monday Tuesday Thursday Friday, so I take my breaks on Wednesdays and weekends, It's been now six months and my viral load is still undetectable!
    Thank you so much for this blog!

    ReplyDelete
  2. Great testimony! That I share because it is consistent with my own experience. This blog is not a medical advice; The practice of explorations, under medical supervision, is to make VLs more frequently.

    What would be great would be that you want to testify further: indeed DTG will pose a new problem: some patients will not succeed Mono-DTG and it is necessary to increase the success rate with selection criteria. Others will not only succeed but be able to go beyond.

    My experience with Mini-DOLU (80 mg / week) is good but may be this is a bit too less; 100 or 200 mg / week may be more appropriate. In any case there will be a minimum.

    Your short cycle pattern is original. I will publish results that are go in your direction. Cutting the pill can help better bio availability. Me, when I take 50 mg or 2x 50 mg, I break the tablet between the teeth. Taking with a meal increases bioavailability.

    It would be nice to start working with clinician doctors: Leibowitch does not show interest in MONO-DTG, and Lanzafame is starting to build expertise in Mono-DTG.

    Well, there is something that makes Tivicay (tm) (Dolutegravir) out of the ordinary! Good continuation and give more news ...

    ReplyDelete
  3. AnonymousJuly 29, 2017

    Bonjour Charles Edouard.

    There is a little more than 2 months that I started my bi DTG + 3TC therapies of attack (you had mentionned in the blog, I am in a foreign country and not able to do hypersensitivity to abacavir I decided With the agreement of my doctor to attempt the blow). I have not yet had the results of my first viral load (I started 48,000 copies and according to me I started the treatment has 8 weeks of infection) but I'm on and I crossed my fingers confident sitting saw The Lamidol results. If I write to you it is because as you can suspect it I feel the side effects of the DTG. I have joints that crack a little, a feeling of being a little less responsive, pain in the body here by the, a little back pain neck ...

    So I'd like to start talking about relief. I know that a lot of people will jump because it's only 2 months but being almost on 98% of the contamination at 8 weeks, and a surely undetectable thanks to the DTG and seeing all the good result of it I think I will start a 6/7 of the outcome that will come out (Monday).

    Now I would like to have your opinion for the future. What step would you follow?
    A 4/7 DTG + 3TC and afterwards even tried the 3/7 and 2/7 or rather a mono DTG and after lightened in 4/7 in mono.

    In the hypoteses that I take 2 or 3/7 DTG + 3TC is there no risk of resistance of the 3TC only? It will not distort its effectiveness?

    Do you think that all these side effects will disappear with the relief or in the end it's just a way to prevent the body but the effects persist.

    I wisely wait for your advice and do not hesitate to tell me if I am too enterprising about my treatment. I am 27 years old, for info.

    Thank you

    ReplyDelete
    Replies
    1. DTG is found in many countries, including those with little or no structure of research and support to the physician. In France, you could not do DTG + 3TC without a doctor's prescription.
      So when you say you do this with your doctor, that's fine! Indeed, here I never give medical advice! Especially since I do not know the means at your disposal, I do not even know in what country you live ...

      With regard to DTG + 3TC, in attack, there is the PADDLE test (20 patients), which gave good results: 100% suppression at S48. A larger US trial is underway, by Gulick and Taiwo:
      https://clinicaltrials.gov/show/NCT02582684

      It's underway. We must not prejudge the result, if not, what are the tests used for?
      According to Professor Jacques Reynes, DTG + 3TC also works in patients with mutation 184 (resistance to Lamivudine)

      I am not in your place and I know what I did when I was there: I treated rather early, with a doctor to whom I gave my confidence, more on the good relatonnel than on his expertise.
      DTG was not available and the initial side effects were otherwise severe! But the body gets used to it, it mithridates itself, and, for years it was rather not too bad ...
      By 2017, and knowing now what I know, I would do otherwise. Easy to say ... Today with the test-and-treat we barely have time to turn around.
      Today, I will be more circumspect, before I rush into treatment ... I will integrate the relief in my strategy, and, I will choose Dr. Lanzafame, Verona (or perhaps Lafeuillade in Toulon) because He attacks with DTG alone, on selected patients (totally wild virus, etc.)
      And this time, I will not do without my doctor but with a competent doctor. At the time, I did not know where to turn.
      With DTG, the landscape has changed and it is too early to integrate what it implies in terms of management of the relief.

      Now, arithmetic offers 3 solutions, after taking the time to validate the initial strategy (6-12 months):
      - move gradually to 6 / 7.5 / 7, 4/7 with DTG + 3TC (always with close CVs and medical follow-up)
      - gradually remove the 3TC (always with close CVs and medical follow-up)
      - then move gradually to 6 / 7.5 / 7, 4/7 with DTG, alone

      The 3 pillars are: Efficiency (which is checked for at least 6 months, without derogation), Progressivity, CV close together.

      If one does not have close CVs, one is not ready for progressivity (and his patience), and one presumes (without checking) the effectiveness, then, sorry, but it is not Not my thing, and, I do not even want to hear about it: it is outside framework, a framework so defined to precisely avoid disappointments.
      So, without me ... Better to take his time and succeed his shot, than to rush and miss it.
      Above all, I find detestable people who read diagonally, follow the protocols of the tests only partially, neglecting whole sections, plant themselves and protest by saying that it is because of what they read on the Internet . It's not!

      Think of sharing your experience, your experience, and, please, have the kindness to describe the medical and technical support you have: what is possible in Paris may not be elsewhere.

      This is not a medical advice

      Delete
  4. Hello
    I am under tivicay alone for 21 months I started to lighten after a year of 7/7.
    HIVer since 1999 I had other TRI before.
    At the beginning of tivicay I had quite a few side effects but that are got better over time.
    I was tempted to reduce my dasage to palliate side effects but every time and thanks to this blog 3 words come to mind: efficiency, progressivity and frequent VL!
    Today, I have a good record and an undetectable VL.
    I do all this along with my doctor and I keep going slowly and carefully.
    tritoman

    ReplyDelete
  5. Yes I understand that. I'm in South America. Here the only way we have available is viral load less than 20, CD4, CD8. That's all. They do resistance testing only in case of failure. According to my doctor, the virus here does not have much failure or resistance.
    My doctor was not at all accustomed to alleviation and when I spoke to him he was not too much in agreement. I already had to push for my first line bitherapy. But he is quite conciliatory and will accompany me in my approach.

    The only problem I see is that I can not do frequent VLs. The health system allows only a few VLs per year. So I think to make one from the private sector once I have started my strategy and when I would be at 5/7.

    ReplyDelete

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