EACS-2015 Katlama and Genvoya

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

EACS-2015 Katlama and Genvoya

EACS: Katlama and Genvoya®

predictable cul-de-sac:

Bad choice. Stribild ® or Genvoya ® could jeopardize the transition to Tivicay® monotherapy, a gateway to HypoDolu. ICCARRE and ... 1/7 ... well, with this virologist, you are not there yet. Consider virologist change ...

Buzz: Genvoya® could jeopardize Tivicay® monotherapy

Is Dolutegravir (found in Tivicay ® or Triumeq ®) your absolutely perfect molecule, that overcomes all resistance and prognostics? For naïve patients (who have never taken any treatment or those who have taken treatment but not Isentress® nor Stribild® / Genvoya®) this is the case! It's stunning! The SAILING test (previously treated patients with multiple failures) shows a very good success rate but also some failures in patients with mutations on integrase. This looks good almost everywhere, but not everywhere. There is a border somewhere ... Where is it? What about patients who have never failed INI? Does the absence of failure under Isentress® Stribild®, suffice it to anticipate the same overall success as that seen in patients who have never taken these two drugs? At the border, it is not all white or all black.

The border is this presentation Christine Katlama. We find a complete narration in the article by Catie, here. It's long and tedious; transparencies, in English, are more meaningful. Accounting is the same.

Some Patients who had used either Isentress® be Stribild® / Genvoya® failed Tivicay ® monotherapy.
The gray area, it is there: to have (or not) previously used these first generation INIs . Light gray, dark gray, medium gray? This remains to be determined. But one thing is certain: the 3 patients (in Paris, on 13 having already taken Isentress® or Stribild®) and 1 Barcelona will not disappear from the balance sheet.

The gray area is located there, and, this is quite a disappointment for the patients at risk, and a great victory for patients who are not: patients who have never taken neither Isentress® nor Stribild®/Genvoya®, are free of risk they may consider, without reservation, switching to Tivicay ® monotherapy in 7/7, and understand that monotherapy is an effective firstline therapy, and therefore we can later consider the ICCARRE reductions: 6/7, 4 / 7 and 1/7 (= HYPODOLU).

Ah... I feel more educated!

Recommended by a reader: the latest issue of Catie addresses both Genvoya® and Tivicay® monotherapy.
In France, our HAS [High Authority on Health] has issued a very reserved opinion on Stribild®, so we wonder what the ruling will be for Genvoya® (read here and see point # 4):
[...] STRIBILD has not shown improved efficiency, has a low genetic barrier to resistance, many drug interactions [...]

We will keep here proper accounting, accurately and comprehensively of failures induced by the use of old INIS. The HAS [High Authority on Health] was right on: one should have avoided Stribild® (/ Genvoya®)!

Good reading, 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.

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

Hypo-Dolu: It works!

Hypo-Dolu: it works!

Read in the comments of the post: Stribild EACS-2015 Hocqueloux

Hypo-Dolu (Hypodolu) is a strategy proposed by Dr. Lafeuillade and introduced here. Use the name of Lafeuillade, a worldwide Hiv celebrity, during your visits: it is better accepted than Leibowitch ...

I first made use of ICCARRE, gradually, 6/7, 5/7, 4/7 and 3/7, 2/7, 1/7 with Leibowitch' quadruple therapy (once-weekly): I am very happy with it, not a single blip. CD4 still high and zero side effects: zero zero zero.

I soon found myself with a stock worth 10 years of treatment (I lost count ...).

I was slyly accused of making business of it, which is not true, but, why not?
Treatment, in a poor country costs 100 Euros per year per patient, and mail it would cost much, so, I gave up. Meanwhile, I realized that I could offer the PreP, of course!
I have everything I need to do it. So, why not do it? We know that this technique works and is approved in the US. 4 Elisa tests (at 24 Euros each, one month apart), a monastic life, cloistered in my sweet home, and now my Lou is free (and me too ... Phew !).

I care about my freedom ... I'm possessive, not selfish ... Freedom not just for me, for others too.

P'tit Lou is free, too ... No reason to change ...

Tivicay® reaches our market (expensive and rare) and Prep is (finally ...) authorized (and free of charge...).

While you are at it, better fill your stock with something useful!

Considering my stock, I am ready for confrontation, if necessary, with my doctor, who has become useless and cumbersome. To my surprise, though, he switches me to Tivicay®. I couldn't care less, I love ICCARRE.

I order Tivicay ® + X . + X is what I care for (for Prep ...), so I'm going to the pharmacy and Tivicay ® is now entering in my stock. Expensive ... and useless ...

I gave Hypo-Dolu some publicity ... And I work on my Guide 4/7, which is now well-crafted. I want to make a guide for 1/7. There are 2 formulas for 1/7: 1/7 ICCARRE with Quadruple Therapy (eg Atripla ® + Ziagen ® in a weekly single dose.) Or HYPODOLU.

Jacques Leibowitch invented ICCARRE method 1/7, and I posted a version in French. There is nothing to add. Just read the patent where quadruple therapy (once-weekly) is explained.

There are many possibilities. In practice, this will be (NVP or EFV) + (TDF) + (ABC) + (3TC or F-3TC, it is the same). His trick just work wonders.

When you do this, you understand that only a VL uptake (monitored every month and then every 2 months) can force you to change your mind. The crying sissies won't stop you... We like the once-weekly!

Hypo-on Dolu is even simpler. The weekly dosing, introduced by Lafeuillade is one pill per week. I'll take more, though, with breakfast on Sundays. And it makes me a weekly dosing; my stock fills up and my doctor regains credibility and usefulness.

Let Lafeuillade publish ... I owe him (and Leibowitch) 2 super effective strategies that will serve me for life.

Dr. Lafeuillade is the head of scientific editorial boards: Use his name and this will open new horizons!

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.

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.

the captain's age

It depends on the age ... of the Captain ...

I get asked a question: thus, I answer ...

Perfect alignment of stars! Talk to your doctor about moving rapidly to Tivicay ® + Lamivudine (Ge). Let 6-12 months pass. Then Tivicay ® monotherapy. Let 12 months pass. Then enter the short cycle: 6/7 (6 months), 5/7 (12 months); 4/7 (for life or HypoDolu) with frequent VL, at first.

It depends on what, anyway?

Dr. Weinberg wrote, and justified: the effectiveness of DTG (Tivicay®) does not depend on the dose.

Dr. Sherene Min S has also argued: effectiveness of DTG (Tivicay®) depends on the dose. (Dose-dependent, in English).

Dose-dependent is often understood as in proportion to ... but proportional often means that there is a proportion factor: tricky ... Dose-dependent is the pharmacist's Holy Grail. thousands year old orthodoxy, since we know that a tad of opium is not effective; a bit of opium, you sleep, and too much, then you are in trouble! The dose dependence is a must-have in pharmaceutical development. This is formalized: Phase II trial: escalation of the dose.

clinical trial ING 111521 shows that the number of patients who pass the promising beacon of 400 copies (once there, achieving UD is no problem) are 5/9 (56%) at 2 mg, 5/9 (56 %) at 10 mg, and 9/10 (90%) at 50 mg, in less than 11 days. Weinberg is right: you arrive at the harbor entrance regardless of the dose.

Only, you get faster there with 50 mg. The study was paid for by ViiV ... In addition, it is customary (because of former ARVs) to substitute the speed of the effect to the effect itself. If you had a tumor, you'd be encouraged to see it deflate fast, especially when there racing against time (resistance ...). With Dolutegravir, no resistance, so we don't care, but we can not stop people from earning their salary doing what they were asked to do. This is a mandatory, regulatory study, not a research study.

So, let's assume, for a moment, that the answer is 'in proportion' of the dose ...

Either ... But it is also in proportion to the initial CV.

Paddle EACS 2015 Lamivudine dolutegravir dose dependent FDA cure Katlama

How do we know? Are we really sure?

It is not necessary for the following, to establish irrefutably that this is the case: it is enough to have a reasonable intuition.

In Paddle, almost monotherapy Tivicay®, the results are in the table here. We class the same data in order initials CV, which gives a new table and for those who had not seen the dependence on the initial CV, we decorate the table slanted lines, and there it is obvious .

One can see: it is convincing! Over the resume is faster undetectable low is obtained. It is clear and confirms what was in trying to attack the ING 111521 monotherapy trial.
In this sense, it is consistent with the HILL equation, where efficiency saturates when all the sites 'target' are inhibited and where to add the inhibitor does nothing more.
Therefore, it is more than legitimate to ask questions seriously dose monotherapy for maintenance of Tivicay®.
This reasonable intuition will allow us to understand how the formulation is overdosed, and how to turn this to our advantage overdose.

For now let us remember that:
The efficiency (here in the sense of lowering speed) is:
- Dose-dependent (in proportion, if you like)
- Depending on the initial conditions (CV ...)

Where we Eff = F (dose, CV, ...) either: Eff. is a function:
- Increasing the dose
- Decreasing the initial CV
And why not...
- The age of the captain ... ;-)

Retain the effectiveness of dolutegravir is not a function of dose; it is up to the problem posed: dosage adjustment is possible!

We will use this in a forthcoming ticket and exploring the Buzz Genvoya®

Buzz Genvoya ®

It's the Buzz! Genvoya® (or its predecessor Stribild ®) could jeopardize the chances of successfully Tivicay® monotherapy, which is the gateway to Hypodolu. To be continued ...

Good weekend and good fuck ...

CRISPR Heroes

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.

CRISPR Heroes

Heroes CRISPR diabolical ... Fables

CRISPR-case.9 is a new publishing method of DNA; it opens up new technical and industrial prospects: read this article World. This is the subject of fashion. And already the subject of controversy. Which can be patented? Who can claim the Nobel Prize?

Any resemblance to the issue in question of Who discovered the virus? Who can patent the corresponding test? The 'Nobels' crush the non-Nobel notoriety? Any resemblance ... Is not coincidental. The story repeats itself ...

We remember that Paris (J. Chirac ...) had dared to stand up to Washington and get a deal.
The time when Paris was audible are gone ...

The squabble explodes in the public space by a historic apology published in CELL by Pr. Eric Lander, excellent teacher and inspirer of great projects, boss of the BROAD Institute, big thing full of money, at Harvard. The free version, complete, is available in my complete bibliographic record, which can be downloaded here. In "General."

The controversy: to simplify, CRISPR is great because:
- This is applicable to humans, therefore Zhang (Harvard) and patents deserves Nobel Price
- It is applicable to all, so Doudna and Charpentier deserve Nobel and patents

Yesterday, European research base. Today patent war between Berkeley and Harvard.
The temptation is to write the story in his own way, and to silence the warning.
It reminds us how to reach a consensus on the Nobel (HIV), it took some deviate. Leibowitch left interesting accounts of that time. The Nobel award more than 3 researchers. And this is not the discovery itself that is honored.
The twenty-first, it's a shame ...
Berkeley replies: with this ticket of Michael Eisen, see this post N. Comfort.
It is true that the maneuvering Lander has dug up the hatchet.
There is something amazing to see an evil genius at the top of his art, and Eric Lander is a diabolical genius at the height of his art.
The recent trial in Lander CELL entitled "The heroes of CRISPR" is his masterpiece, at once so diabolical and yet so brilliant that I find it hard not to stay stunned even if I ' imagine cackling loudly in his den Kendall Square, giant laser weapon in the back, ready to destroy Berkeley him if we do not challenge our patents.

truncated Studies and spin-doctors diabolical

What is important here is the extraordinary ability of the spin-doctors, crowned with sounding titles, to accommodate the sauce that suits them. Even amputate design information.

With us, it is the SMART START and testing, we are rehashed all the sauces. Critics have dared to point out that the excess mortality had not taken place in Europe. Are reduced to silence or marginalize.

In SMART, excess mortality is concentrated in the US (mainly cardiovascular, 92% of deaths for Americans 50% of participants!). In START she appears only in the townships of South Africa, the failing health care system: tuberculosis, suicide, homicide! inconceivable risks with us ....

Geography has a more decisive role that the treatment strategy. But hush!

Transposing among us shamelessly risks that exist elsewhere. Diabolical...

Those who have the means to carry these media battles earn.

Yet our lives are worth more than their profits. Our patients deserve better ...

Reservoir measurements-1

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.

Reservoir measurements-1

Measure your tank: # 1 total DNA-HIV

The draft Backonstage
[...] I am observing seamless, undetectable for 15 months and no further infection with my virologist then we decided to test the mono Tivicay ® ... strong advice of Charles Edward, his arguments did fly ... [...] Beginning February 23 for me and the first record on April 4 and then 1 every month for 3 months, then every 3 months 1 for 6 months and 1 per semester
A Charles-Edouard
I adore you you're really top ... Where are you taking all this knowledge ... THANK admirable

Back, you read me a long time. If I could be useful to you, you see me happy. I wish your project to succeed as much as mine.

How to measure the tank?

Christine Rouzioux we read here (magazine of the French Society of Virology)

The quantification of total DNA-HIV is by far the most used method. It can be applied on red blood cell, PBMC samples (Peripheral Blood Mononuclear Cells) or whole blood. It measures all forms of DNA-HIV present in CD4 + T cells and monocytes, whether integrated or not integrated. This is a global approximation that can be criticized because of variable effectiveness without doubt to extract and amplify the different forms of HIV DNA within the same sample. However, it remains the simplest [...] and usable in many laboratories.

The reference method, it consists roughly to infect a blood bag and see what happens (Viral Outgrowth Essay). In fact, the only method that puts everyone agrees it is to interrupt the frequent monitoring and see when it bounces, in vivo.
The top = measuring time to rebound.
I look 2: measurement of total DNA and HIV-time measurement rebound. I speak here of the total DNA-HIV, now available in lab city. Well ... It wipes the plaster.

Rouzioux total HIV DNA tank Siliciano Hypodolu Salpetriere PCR Viral Outgrowth Essay Already, check your lab does. The CBCV fact they subcontract to the Salpetriere.
Again, this is very recent, it is appropriate to go where we can.

1 It is not therefore not reimbursed codified: So ... Results: within 3-4 weeks
2 it costs only 70 Euros (out of pocket)
Indeed, even when one considers the relief, it has no practical use. The idea that the reduction is done under reservoir condition is false, nothing justifies, and even made Leibowitch proven otherwise. How clinical decision the extent the total DNA-HIV can she drive? In practice no! Unusable, therefore, not reimbursed by health insurance (and that's good and it suits us!)

3 can have its result without going through the doctor box
Genetic analyzes are delivered by hand by the doctor. It's the law ... This is a count, not a DNA analysis: there are blind ... If we refuse to give you the result, ask the service biologist understand and give you your results. Otherwise too bad, wait until the next visit to the doctor.

4 as it is not paid, your doctor can hardly deny you the order.
Indeed, it is useless ... So we do not pay you! But as you pay for and this is more a bottle when your blood test, therefore, safely, on what basis your doctor Could you refuse the order? ... Bingo!

Now you know to do now ... Do it ... Be aware from his own experience that it is possible, simple and useless is a good way to put hysteria tank in perspective.

We have fun with the toys that have been ...

Note of 30.4.2016: I added the interruption by analytical method.

Good Night and Good Bourre!

Katlama EACS-2015

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.

Katlama EACS-2015

Katlama EACS-2015 (Poor Genvoya ® ...)

Read in this lively discussion here:
[...] It would not give me Tivicay ® monotherapy ... so: Tivicay ® + Truvada ®.
600 + 500 euros !!! 1,100 euros / month = this is crazy!
I wanted to try Tivicay ® (+ possibly associated with Lamivudine) but she refused. I hope I do not have issues like in September with Triumeq ®!
What do you think ?
Eviplera ® damn transformed me physically ...

It gives you everything you need to succeed: You do the sorting for some time, you valid (close CV) you let Truvada ® in the closet, you valid (close-CV). Well ... Did she spun monotherapy air to touch it ...

There are only two questions to ask:
1 - Tivicay ® monotherapy (m ') is it possible, and if so?
2 - maintenance, 10 mg is it as good as the 50 mg?

Tickets for EACS-2015 starts here ... Here I pruned the summary of the presentation by Prof. Katlama EACS (Salpetriere, see here) (transparencies are there). This is the perfect example of the study when it is appropriate to read the details: in addition, details are presented. Thank you Christine! If the earlier use of Stribild ® (now Genvoya ®) closes the door of the monotherapy of Tivicay ® 1/4 of these patients, and only to them, they make the mouth!

HYPO-DOLU EACS 2015 monotherapy Tivicay dolutegravir Christine Katlam Genvoya Stribild Barcelona hiv Background: [...]. Dolutegravir, an inhibitor of the latest generation integrase (INI) with high power, long half-life and high genetic barrier in vitro and in clinical studies has potential for monotherapy. Methods: This observational study recruited patients with HIV-RNA CV (VL) <50 cp / ml for at least 12 months, CD4> 350 cells / mm3, with no faults INI; they changed their effective treatment for mono-dolutegravir 50 mg / day. [...]. Data are presented to S24.

Results: 28 patients in total with a median of 624 CD4 / mm3 [...]. Thirteen patients had prior exposure INI (n = 13). DNA median was 195 cp / 106 cells [94-641].

The proportion of patients now VL <50 cp / mL was 96% (95% CI: 79-100) to S4, 100% (85-100) to S8, 93% (76-99) to S12 and 92% ( 75-99) in S24.

Three patients [...] had a rebound with the emergence of resistance mutations INI [...]. The concentrations were in the normal range in all three patients. genotypic resistance retrospective analysis based on DNA-HIV showed no INI-RAM [mutation associated with resistance INI] in patients exposed to Inis pt except for # 1 with 74I previously under suppressive therapy containing elvitegravir .

[...]
The usual Cassandras, journalists photocopying, useful idiots, were too quick to point out the failures 3, indiscriminately. By hiding us the details.

Among the hundreds of patients who tried the monotherapy Tivicay ®, there are only 4 patients where it makes the least (1 in Barcelona, ​​3 in Paris) and in every single case the prior use of the INI first generation ( RAL or EVG) is mentioned as an explanatory factor.

So, I would ask the question:
It is known to contain the risk only patients who used the ancient INI. For others, what about the dose?
This is, among other things, that you propose to explore in future posts.
For us, this study Katlama: it's great! The victory assured!
The results PADDLE (Dr Cahn) and Katlama-EACS2015 open a new field. Stay tuned: our victory is there; our enemies are struggling, unsuccessfully, such fatty fish out of water. Poor ... they entangle themselves ...

Good weekend and good fuck!

Monotherapy: Olé

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.

Monotherapy: Olé


Monotherapy: Olé!
I'd like to go around the world for about 6 months: How to treat? I can not go back to France every month [...] If I understand you started a therapeutic relief to reduce the number of drugs and thus need fewer pills during your stay abroad.

I already told my doctor relief and he will not do it [...]

Otherwise I might be forced to return after three months, it looks like a prison, in short, thank you for your help :)

The only passage in the monotherapy Tivicay ® does not respond to this question: we must learn to reduce the dose: it's healthy and useful.
With conventional treatments: ICCARRE 4/7 or 1/7 (4/7 ICCARRE enough to this project); with the monotherapy Tivicay ®, consider dose reduction or Hypodolu.
Monotherapy Tivicay ® has the wind in its sails. It is understandable...

And for the stock, there is only one way: save, thus reducing the dosage.

There are only two questions to ask:
1 - Tivicay ® monotherapy (m ') is it possible, and if so?
2 - maintenance, 10 mg is it as good as the 50 mg?

Tickets for EACS-2015 starts here ... Here I pruned the summary of the EACS presentation by Univ. Barcelona (transparencies are here):

HYPO-DOLU EACS 2015 Barcelona monotherapy Tivicay dolutegravir Esteban Martinez Barcelona hiv

Dolutegravir Monotherapy in HIV-Infected Patients with Sustained Viral Suppression: A 24-Week Pilot Study, J. Rojas et al.

Goal:

[...] We have tested the feasibility of dolutegravir monotherapy in patients with treatment options limited due to toxicity problems, interactions, or resistance.

Methods:
Patients without failure or without mutations previously documented proven resistance to integrase inhibitors and with plasma HIV-1 RNA <37 copies / mL for at least 12 months had their antiretroviral treatment (ART) changed dolutegravir 50mg OD [ ...]. primary endpoint was the proportion of patients without new treatment failure (do not go through = failure) at 24 weeks.

Results:

33 (22 IP-18 in monotherapy) patients were included [...] 39% with prior AIDS events, 8 (4-13) years with undetectable HIV viral load, CD4 596 (420-843) cells / mm3. [...] Only one patient of 33 had virologic failure at week 4 (88/155 copies / ml). It has been recommended that increasing the dose of dolutegravir 50 mg BID, but he continued 50mg OD. Viral load remained detectable at 24 weeks (79/101 copies / ml). RNA genotypic resistance tests for HIV and DNA at 4 and 24 weeks did not detect any mutation of the integrase. [...].

Conclusion:

Dolutegravir monotherapy is an option that remains to be confirmed in randomized clinical trials.

What remember: it goes smoothly. One exception (of 37 patients): a multi-treated patient coming, especially a treatment with raltegravir (Isentress) this 'failure' with little consequence because the CV is very low: the patient remains under monotherapy Tivicay ® 50 mg / d. Note also that the mutation (118R) is a mutation cul-de-sac that reduces slightly the efficiency of DTG without opening a path to other viral mutations and therefore exhaust.

For us what matters is that it seems to work for 32 of the 33 patients (96%). For one of the two patients who previously took an INI first generation, it does, for the other less ... and when it makes the least, what is proposed? Increase the dose ... The second line following Tivicay ® is Tivicay ®: it is its own antidote.

Question: (? Horse, initial) when it does, what is prohibited to reduce the dose

To repeat: 95% of patients, stable and undetectable, are unnecessary and harmful on-medication!

WHO proves us right

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.

WHO proves us right
WHO gives us reason!

It is not allowed to change your mind ... We read with relish this:
There are obvious advantages to treat as soon as possible:
- Avoid the virus develops in large numbers and settled in reservoir cells where treatment can no longer reach
- Be quick undetectable and therefore not contaminating
- Avoid all risks of opportunistic diseases
- Then go quickly to a lighter treatment.

The relief available to earlier treaties, this is factually untrue. Well ... There is progress ... It's hard, but it fits ...

Dose reduction is sometimes presented as an exception, conditioned to a blood test. It is practiced as well in Geneva and Quebec. It is too restrictive.

Dr. Lanzafame (Verona) is the reduction of maintenance dose, without selective condition, other than undetectable achieved and maintained a good time. Dr. Leibowitch same: de facto, its short cycle (5/7 or 4/7) reduced the dose received. Dr. Cal Cohen (FOTO test, total success) even published its concentrations (C Through) well below the concentration 'recommended'. Dr. Lanzafame also published verbatim by patient patient, pharmacological results: undetectable is maintained in all patients including those whose concentration is very low.

The approach went Lanzafame is the universal reduction: it is not conditioned. He tried several maintenance formulas: protease inhibitors, integrase, or non-nukes (Nevirapine, Efavirenz). Total success every time.

Clinicians, poor countries have done the same ... Funding Gates for 12 million USD. This time, in treatment of attack: these are the ENCORE-1 trial, ENCORE-2, EVEN-3. Again, with success.

But what thus takes them all to question the dose imposed by the manufacturer and approved by the FDA? And see, every time, it works!

Try it (must still try ...) it is to adopt.

This is what comes to the WHO, against the current pharmaceutical lobbies, and for the greater good (mental) millions of patients: The valid WHO reducing Efavirenz 600 mg to 400 mg. It is here, p.7.

WHO Lanzafame efavirenz encoure1 hiv hiv AIDS WHO TLE400 Cipla Mylan 400 mg

[WHO] also recommends the use of a dose of Efavirenz 400 mg as an alternative option for first-line for adults and adolescents to enhance the tolerance of efavirenz, following a finding that 400 mg dose was as effective as 600 mg, but with fewer side effects.

The Indian manufacturer Cipla announced this week that it is preparing to launch fixed-dose combinations containing 400 mg of efavirenz. Mylan Laboratories will also launch its own fixed-dose combinations in early 2016 at a price of $ 99 [NdT: year]. UNITAID said that the transition to a 400 mg dose of efavirenz could result in savings of $ 80 to $ 100 million (US) globally by 2020.

The cons, Dr. Gottfried Hirnschall (WHO).

At Mylan, the drug in one pill, once daily taken, bears the name of TLE400. Read the press release.

Manufacturers will apply for approval to the FDA, and get it, why doubt it? It is required to provide the international donors (American ...).

The valid WHO, FDA approved, but you, you are not entitled ... Why?

As effective, with fewer side effects, it's best! Point bar.

Well ... Let us rejoice: The relief came at WHO, without fanfare, but went anyway! When it's in, that's it!

We will discuss the implications for us in a future post.

By then join the discussion. The most active is in Stribild EACS-2015 Hocqueloux

Good Weekend and good fuck!

The brilliant Dr Cahn

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.

The brilliant Dr Cahn

The genius of Dr. Cahn

Tivicay ® monotherapy, interested. I received the following question:
Under Stribild ® for 2 months on the front line, went to Eviplera ® and Truvada ® + ® Tivicay. Always side effects of Truvada ®, I would experience the mono Tivicay ®.
Why have undergone ® Stribild a priori it could without resistance we exclude from mono Tivicay ®?

I give items on the comment of the ticket: Stribild ®, EACS-2015 Hocqueloux

Questions help me build the note on the presentation of Ch. Katlama at EACS-2015. Thank you! For the impatient, see the slides and abstract.

Given the total blackout in our favorite media, I'm in no hurry ...

The future of therapy under the dolutegravir angle (Tivicay ®) is easy to envisage.

There are only 2 questions to ask, to collectively and individually:
1 - Tivicay ® monotherapy (m ') is it possible, and if so?
2 - maintenance, 10 mg is it as good as the 50 mg?

2 questions, not one more ...

The genius of Dr. Pedro Cahn is to have responded, in part, to these two questions at once.

Its Dual Therapy of attack, without fail, on naive patients, that in the mouth corner. Especially as Lamivudine, hanging keychain with DTG, is very powerful, and do not synergize with DTG.

This almost monotherapy in treatment of attack open, obviously, the door to the results in attack monotherapy (*). It will eventually come out, probably in 2016 ...

Already the US are building their pitch to finance a large trial on maintenance of combination therapy DTG / 3TC. And again at home what is already acquired at home ... The test, ASPIRE (NCT02263326) is announced here, is no different from our test LAMIDOL

PADDLE, too, will be remade in the US: NCT02582684; by the AIDS Clinical Trials Group

The ING-111521 trial has already shown that monotherapy Tivicay in attack on naive patients, it is possible. The clinic will confirm what we already know.
This same ING111521 test which allowed the manufacturer to claim that 50 mg is better than 10 mg. The higher the dose, the greater the response is quick: the speed of response is in proportion to the dose.

True, but we, we do not care: what interests us is the maintenance of the response.
Not the response speed, the attack ... It depends, a bit, of the dose.
Dr. Pedro Cahn shows that it depends mainly on the initial viral load.

Paddle EACS 2015 Lamivudine dolutegravir Dr Pedro Cahn undetectable

I have classified the patients, the picture presented by Dr. Pedro Cahn, by CV before treatment. (See this post)
We see very clearly that undetectable long in coming when the viral load is high.

And also, that entering the home straight, passing under 400 copies, ensuring the ultimate success, is obtained from the 10 th day (look, this is true for 19 patients: 19/20), as in the attack monotherapy trial: ING111521 (9/10)!

With or without lamivudine, the result is the same ... (*)

So, one can bother taking lamivudine (300 mg, 1 time per day) at the beginning. Without losing sight of removing this accessory, futures (*).

The test PADDLE (*) thus sheds light on what ING111521 plans: the maintenance Monotherapy Tivicay ® is possible. (*) = Treatment-naive patients, therefore / or have never taken INI

It also illuminates the second fundamental question: 10 mg instead of 50 mg, is it sufficient for maintenance?

You do not see what PADDLE sheds light on dosage reduction? See you soon for a future post.

It's fascinating, is not it?

ICCARRE and remission

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.

ICCARRE and remission

ICCARRE and remission

I deliberately differs ticket which discusses the presentation of Ch. Katlama at EACS-2015. For the impatient, see the slides and abstract. This is the final blow ...

The questions people will start retrospectively to ask are devastating ...

Tough for doctors: my doctor is zero, its entire design is destroyed:
- Yes, the TasP, it works
- Yes, it works the PreP
- Yes, there are non-drug interactions described
- Yes, it works relief

My doctor is destroyed. I want him in a bit. Even many ...
I see that the change will be painful. Looking back ... All this wasted time and all this unnecessary suffering inflicted. Today and tomorrow ... How to manage the inevitable turning towards the relief?

Here are a few open questions: What is Triumeq ®? Is prescribe Stribild ® today do not restrict future options?

Should we wait? Yes ... we can wait ... wait what? Wait until when? At one point, he must turn his cuti, and change software.

If doctors do not change now, they will find themselves at odds vis-à-vis patients, which themselves are asking questions and finding answers.

Yes! ICCARRE it's a good plan! ... No doctor (not the unique case, not reproduced, Hutter, Berlin) has never offered not even a year of remission in chronic patient.

Leibowitch, Cohen, Faucy, Dybul, Butler, for ten years or so, demonstrated the concept pharmaceutical remission. Leibo explained here.

Reducing medication on 40-85% ICCARRE offered an average of three years of remission without medication and without virus per patient, saving approximately € 3 million for only 94 patients [...]. In addition, it should be emphasized again, 4 days / week, there was no any viral escape, among 94 patients. Over 10 years, avoid over medication, useless, equivalent to a saving of four years without HAART and virus free.

Even among the few Visconti, only a few have a lasting remission: the vast majority, the honeymoon lasts only a few months at best a few years: They count their years of remission.

How do they count their years of remission? They contemplate the years of non-drug taking, triple therapy years remained in the closet.

Well me too ... I can do the same ...

ICCARRE HIV cure HIV remission Lamivudine relief sparing economy Visconti
There are so many that it's not easy to keep everything on a photo. There are so many! To facilitate taking pictures, I am limited to lamivudine, since it speaks to everyone: almost all patients taking lamivudine, fluoridated or not, coformulated or not. If you see 3TC or FTC in your combo, then that's it ...

This is not it poses a problem of toxicity identified (although ...) is that goes with it ... And then the accessories, toxic, are varied. I circumscribe the Lamivudine, it speaks to everyone. In his head, just multiply by 3!

I have to Leibowitch (and certainly not to my doctor ...) years of remission!

To discover: Here a recording transcribed by the family committee:

ICCARRE HIV cure HIV remission Jacques Leibowitch Garches relief
If doctors do not do what I [Leibowitch] do, that's their problem and it is your problem. Defend yourself, demand your right to fair dosage, because it's going to be real news to me. The news is yes, you can reduce 40 to 80% HIV maintenance treatment. That's the good news

That's the good news!