Gvt Health body torpedoes Genvoya(tm)

Gvt Health body torpedoes Genvoya(tm)
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.

From a patient who has poorly maneuvered:

What a journey! You toasted almost all your treatment options simply because of toxicity that you, and you alone, allowed to break in... Bravo!

Apart from the initial phase, your new combo has a very low dropout rate. This one remains widely used, to the chagrin of merchands. The Genvoya ® proposal will then have no interest.

If the patient has a proactive doctor: the 'promise' for relief that was made to encourage the patient to enter early in treatment, will be held. If the doctor is of the reactive type (relief only if under duress) the promise of yesterday will quickly retracted.
Remember to ask about what happens next before running to the slippery slope

In the first few years of its release, no one had seen the toxicity caused by TDF (which is in Truvada®). No one. No one; neither phase 3 trials or systematic monitoring done by D: A: D: S. And this, everyone has forgotten.

Toast an option due to resistance or due to toxicity, it is the same shit!

If the doctor is seasoned and proactive; the 'promise' of a lower medication burden that entices the patient to early treatment, will be fulfilled. If the doctor is of reactive type (lesser medication load only if under pressure) the promise of yesterday will quickly be retracted.

You want to take a second opinion (in a perspective a lower burden): you are proactive.

And, if you go to a reactive doctor, same as your current doctor, you are fooled again. And you can not know in advance: doctors not to put their 'profile' under their name

HAS torpedoes Genvoya®

Translation Note: the HAS (Haute Autorité de Santé) is a French gvt body, established in the wake of the Vioxx and mediator scandals; An equivalent to Britain's NICE. It aims at protecting patients and doctors again falatious claims.

The HAS ruling concerning Stribild® was already severe: it had positioned Stribild® in second line.

It points: [...] the low genetic barrier to resistance to elvitegravir and the lack of demonstration superiority in terms of effectiveness compared to other available INI (Dolutegravir, Raltegravir), and the need for a pharmacokinetic enhancer, Cobicistat, [...]

Genvoya® is nothing but Stribild® where TDF was substituted by TAF. Here is piece in Pharmaceutical that introduces the trick: This is an incremental innovation, which the Transparency Commission of the HAS has also denounced no improvement in actual benefit (although benefit is important)

The 2 reference documents are:

TRANSPARENCY COMMITTEE, Avis and March 2, 2016 and SUMMARY OF OPINION OF THE TRANSPARENCY COMMITTEE; General access is here.

About Genvoya®, it says: When a treatment strategy with integrase inhibitor is considered, Genvoya ® is a second-line treatment option.

In short: Say, you are under Atripla ®, and your doctor offers Genvoya®. If you want to follow the opinion of the HAS (or simply if you want to avoid Genvoya® food obligation): simply show this ruling to the doctor. Does s/he considers a treatment strategy with integrase inhibitor? Obviously, yes. Can s/he suggest Genvoya®? Well no ! It should first try the alternatives: Raltegravir (Isentress ®) or Dolutegravir (in Triumeq® or Tivicay ® ®)

If we follow the HAS (May 2016), Genvoya ® should only be considered as a replacement to Stribild® or Isentress ® . HAS denies the use of Genvoya® outside this context of historical continuity.

If you go by the HAS, Genvoya ® should never be your first treatment, or even, in the vast majority of cases, your second. At the earliest, this will be your third ...

For a relegation, that is a relegation! ...

And that nobody talks about ...

HAS: schizophrenic and obsequious

Having thus torpedoed Genvoya®, HAS will engage in an exercise of unprecedented baseness.
So, it had just disqualified for lack of improvement (TAF weak evidence of toxicity reduction), but, in the same document, it pleads the manufacturer to promptly substitute TDF by TAF, in other products . It has nothing to do with Genvoya®, but they write it there, in the ruling on Genvoya ®: message well received or a shot in the dark?

France, now a pharmaceutical dwarf, forced to supplication.

As if the US were to return a favor as they just sunk their flagship to the sea floor!

Genvoya ® HAS got it right: the trap is set for you

HAS saw it coming: in a future post, I 'll report how a Quebec doctor screwed a patient. For him, the pill is bitter: if he had read us, he would have thought twice.
This case illustrates a scandal being put in place: it is the same order of magnitude as the tainted blood scandal: the problem is known, but the alarm is not sounded.

By definition, the trap is concealed: it is enough to reveal the mechanism for curdling terror. To be continued...

Comical: the Seroneg's coming-out

Seronegative explain life to poz, as read on the Web, and worth reflecting upon:

Weird story about the 'AIDS' organizations: An official at a local 'conference' (AIDES) talks to about twenty HIVers on how to approach life ... I ask him if he is HIV positive, to what he replied that he preferred to keep the answer for himself! ... I left the room, protesting that announcing one's HIV status could be a problem that adds to the one of announcing one's HIV negative status!

Have a good week-end and good fuck!


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.

Pr. Delfraissy's surrender

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

The ANRS announces Quartuor:


The introductory course is done in 7/7 ... Should we now recommend 4/7 days in current practice? NO said Delfraissy / ANRS: Pffffff !!! It's hard to have put our trust in these guys ...

ANRS-4D: there was cheating and even sabotage: the results prove it!

Two camps clash: Septists against Tempists

- The septists, infected by a Septisticum parasite: they only swear by 7/7strategies
- The tempists, proponents of the Viral Eclipse: the virus takes 7-21 j. before showing its nose: They follow the Tempo

It is by no means a 'enlightning' camp versus a 'conservative' camp. No, on one side we have the septists on the other, the tempists.

- The septists have an apocalyptic vision: 7 days otherwise, the Apocalypse
- The tempists have a temporal vision: the action adjusts to the viral tempo

I have used ICCARRE 1/7 and HYPO-DOLU (another 1/7): it works. So be it. When you witness the 1/7 at work , then you understand.

There is no question here of a showdown "massive therapy" versus "lighter therapy", but Septists against Tempists.

The ANRS and the blow snow job.

This is not a tiff amoung pharmacokinetists, between Peytavin one side, and Alvarez on the other. Between the proponents of a minimal plasmatic concentration, and the proponents of a residual concentration in the cell.

No, this is something deeper: the virus is integrated into the genome: it is comfortable, don't bother it, is is napping: it is the Sabbath, a long Sabbath ... It is a lentivirus, after all.

The confrontation was deferred by the desire of Prof. Delfraissy. It has happened: they are defeated.

The surrender is booked: there is no place for rear guard skirmishes.

SURRENDER does mean SURRENDER.

RESIGNATION is not our purpose (it's inevitable, so without interest), because actually it is the SEPTISM, which infects the entire profession, that surrenders.

Among the first to have published on the viral Eclipse, we find Antony FAUCY (the Big Boss at NIH) and Mark Dybul: it dates back to ... 2003!

It is the confrontation of the Alliance Faucy-Dybul-Leibowitch and Axis Ananworanich-Delfraissy-Katlama.

The SURRENDER, dear Professor Delfraissy, is not a "peace of the Braves": the SURRENDER is to let its territory to the winner: the real-virologists who-have-understood-the-virus: we can no longer accept SABOTEURS, who may compromise the upcoming new age. How can we accept cheating and sabotage in an ANRS?

Losers must recede: we will put them to trial them in due time.

The judiciary suit, the evaluation of the ANRS, all this will take place, in due time. The Pr. Delfraissy, perpetually tanned, is not just a one-time fuse: the entire Septism collapses.

A crooked medico-capitalistic construction will disappear, it is inevitable; since the Viral Eclipse is a factual reality.

It is known and recognized by FAUCY-the-Great who finally wins. Will Delfraissy and his tiny ANRS go against FAUCY-Dybul-Leibowitch?

Applause: Delfraissy, the artist, the man who we will have cost us 3 billion, has capitulated: Quartuor trial has been announced, even before being conceived: 640 patients!

Why 640? Is the size, 640, up to the challenge?

Yes, from the perspective of those who panick-decided, to save face, diffuse the bomb.

No, from the point of view of the victors, the scientific virology Alliance, attached to the facts

Facts are stubborn, the Eclipse Viral exists, it is measurable, I explained how to do (if you want to have fun).

In the Anticopernicus world, the Eclipse is denied. Copernicus, Newton win because they predict the Eclipse, and the commoner can see with his own eyes. Anyone can measure the eclipse, if wanted ... I started a post series here, and here. The measurement is not so important, as long as you know how to benefit from it.

Applause: Delfraissy the artist, the man instrumental in postponing , yet launching, ANRS-4D ... Exit through the back door or face-saving matters little to us: patients are not fooled by the guilty procrastination: patients who can not register to Quatuor, due to lack of spots, will need a solution.

And Congratulations to Leibowitch to Truchis, and other advocates of the Faucy-Dybul insight. Thank you for the hundreds of years of pharmaceutical remission ...



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

First Line Dolutegravir monotherapy

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

This post is a follow-up to attack monotherapy and monotherapy of attack: the scoop.

jesuisdutreize, true pioneer, opens the frontier (in maintenance):

We fear Nope: an firstline therapy is taken, the virus is blasted, you let it cool, then, allow it a siesta and you maintain with 4/7. It was nontheless necessary to realize that Tivicay® Monotherapy is an effective firstline therapy (finally ...). If it had been possible with AZT or PIs, we would not be here, with these new questions. If the manufacturer had not cleverly obfuscated results, we would have realized faster!

Lanzafame opens the show: FirstLine Tivicay ® Monotherapy

Like us, Dr. Massimiliano Lanzafame opens his account of experience with the extraordinary results of ING 111521 (the page in French is more complete).

He recalls: Ddolutegravir 50 mg demonstrated a high power with a reduction of 2.5 log after 10 days of monotherapy.

We said: Log 2.5 is a low-estimate: maybe this is more!

The results speak for themselves:



Crystal clear: First line Tivicay® monotherapy : 9 naives patients = 9 success !
How many successes with First line Tivicay® ?:
- ING 111521 : 8
- Dr Lafeuillade : 1
- Dr Lanzafame : 9
Total : 18 (very good!)
Here, we are expecting confirmation results by Pr Katlama (Paris) ... We are not the least worried!

Normal values vs desirable values

The normal value is estimated as follows: take patients without problem, measure, calculate the mean and standard deviation and anything above (say, 2.5% below and 2.5% above) is deemed not normal.

The 'normal' salary and the desirable minimum wage, are not the same thing!

Desirable: looking at patients without problems, and those with problems, and put a threshold: those above are less problem-prone, those below are more likely problem-prone.

And it's not the same! And not the same at all times ...

Example: CD4 value 'normal' is 800, and, say, greater than 500; the desirable value is > 350 (for short ...)

To determine the desirable value, one must look at Joe-on-the-street patients (excluding those who already have the Achilles heel, it is another matter, and not a matter of concentration) who fail with dolutegravir (excluding other causes such as toxicity). To do this we will have to find patients who are failing with dolutegravir: good luck! Do you know patients failing with dolutegravir? Good Luck!

There, it's that simple: pharmacokineticists are unable to document a desirable dose ... And no one raises the question: why? How come? No ... They do not care. We force-feed, we force-feed ...

Well, then the force-feds are fed-up and fire the quacks: and this is normal!

Sorry... This is desirable !!!

Good Weekend and good fuck

ANRS-162-4D: cheaters are exposed

ANRS-162-4D: cheaters are exposed
This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.

This what ANRS-4D uncovered

In short:
- J. Leibowitch was right: you can follow the 4/7 schedule, within the rules
- Eviplera ® (Complera ®) is eligible 4/7
- You can go direct to 4/7: bypassing 6/7, 5/7
- There was cheating in this trial
- There was sabotage in this unsponsored trial (see below)
- No intrinsic failure in this trial
- For patients 100% eligible and 100% adherent, regular VL inform us of nothing: they are useless

2 cheaters: revealed by their concentrations!

No doping! Not cheating! No cheaters: dosage reveals who pees blue, and also those who do not take their meds at all!

Le Figaro exposes the cheating:

"Of the 4 patients failing, one quickly abandoned by fear, and two are unlikely to have followed their treatment," says Pierre de Truchis (Hospital Raymond Poincaré), who led the study.

Yes, of Truchis has indeed granted an interview! He leaches out here:
Dr. De Truchis: ... two of the three had low plasma levels of drugs which suggests they did not take quite the expected dose of drugs.

Who are the 2 patients in question? identifying 2 patients 3 on low dosage criterion is easy ... Since 1 of 3 patients always a largely measurable concentration.

Patient number 2 obviously take Atripla ®; he has Efavirenz concentrations, while ON, well above the average (3669 for an average of 2218 among 100 patients) and, while in OFF period, has 1543 (an average of 692 when OFF), which is even a concentration worthy of ON. If de Truchis accounts that patient #2 as one who does not take these meds, he will have clarify. Because, in the published poster, patient # 2 taking his medication properly.

Who are those, then, who do not take the dose as ordered by the trial? Apart from # 1 and # 3? Whose doses are so low that they are not detected. Including in the period in which they were supposed to take meds. So that's quite clear.

You have undetectable concentrations when you are supposed to take medication and that you claim 100% adherence: you are lying!

Dear: Your doctor has prescribed Kivexa + 1 protease inhibitor, to be taken daily, and you miss doses? We understand you ... You are in a vicious circle: you are under PIs, you miss doses, your doctor realizes it, fears resistance, so leaves you under PIs. We understand your interest for the short cycle. We understand ... But you lied to the investigator ... Your lie costs us: redo the trial, delay deployment of the strategy for yet another 3, 4 or 5 years. The millions of patients who are waiting for a reliable strategy or simply treatment (because of shortages), do not say thank you! Here your lies have been damaging and are reprehensible.

Note for future trials: people want to go participate in a trial just to have an excuse to stop their treatment should not be included. This should be the first criteria for non-inclusion in the trial. Exclude anyone who would want to participate just to stop treatment.

We always thank the volunteers ... but not the liars!

Cheating (provisional): it does not count!

Read our complete analysis here!


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

Best Doctors List

Best Doctors List


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

A patient writes to Professor Reynes ...

You got it right on! Facing a crappy advice, you want to get a second opinion. Not just anywhere! If you knock on the wrong door, you are misled again. Thus, knock on the right door and invite doctors to collaborate. You still need to know where to knock.

Finally, there are enlightning doctors!

We consider as legitimate reductions:
- ICCARRE (short cycle: e.g. 4/7)
- Hypodolu and ...
- The steps leading to it: Tivicay® monotherapy and dual therapy (eg. Tivicay ® + Lamivudine)

We do not consider IP monotherapy to be a modern relief. Other crappy things offered at Hospital Bichat? Stay away.

The list of alleviating doctors gets longer and you can contribute. [note: French page has more]

Tops and Flops

top

He is the fronrunner: Dr. Pierre de Truchis with 190 documented successful cases he has become the toast of Paris.

190 successful cases, duly identified, with minimal entry criteria. He knows all the cases.

The pedigree is beautiful: he works at the same Hospital as Dr. Leibowitch, now retired. De Truchis is less flamboyant.

Yet de Truchis is the King of the day! Our Top # 1.

He is worth the trip (and the waiting time ...). If you can not go or do not want: ask your doctor to get in touch with him. Especially since he has no need to wait for the results of the Quatuor trial... 190 4/7 success: he knows them by heart!

Icing on the cake: he knows how to prescribe 1/7!

De Truchis = 190 4/7 success (also 1/7) and 800 years-worth of pharmaceutical remission !!

the Flops

The losers of Parisian virology: simply put : Hospital BICHAT and Docs (or pretending to be) : Molina, Goshn, Rouzioux, Katlama, Delfraissy and semi-losers (neutral, thus not neutral ...): Dr. Gilles Pialoux, etc. Run away! Run away!

Vote with your feet!

They should not be in 'specialist' positions anylonger! They should work in less perillous jobs such as prevention , PreP ...), at least, there is subsidized work, which we know the origin of the subsidy.

Learn to say goodbye to Dr. Knock: No regrets: it's not that difficult!

According to them, you will never qualify to either mono Tivicay ® nor 1/7, then, no regrets!

It's Summer: Have Fun!

First chat on litgher treatments: August 6 at 10:00

Have fun: are reviewing the videos and releases from our enemies: those who had 'criteria' are now completely demonetized by the results of ANRS-4D, and soon by DOMONO.

The ANRS-162-4D controversy continues throughout the summer and beyond. If you want me to send you the video interview of Dr. Truchis in Durban, July 19, drop me a line (with an email address I will blot) in the comments below

Thoughts for the Summer: Today, and at this stage, the guilty to condemn are not the ones who infect others, but those who benefit from the crime ...



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

ANRS-4D Durban 2016-07-19

ANRS-4D Durban 2016-07-19
This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.



Durban, July 19: The Tidings Brought to Paris

By Charles Edouard!

From a follower wannabee ...

Your wishes are going to be granted! In no more than two days ...!

Understanding the BREATHER numbers is crucial : any dosing reduction trial has failures, this is normal! In the BREATHER trial, the comparator arm helps understand that there are as many (or more ...) failures in the 7/7 arm: this helps to put things into perspective! The misinterpretation of BREATHER is let to believe that Pharmacokinetics prevails: it is not true and I will get back to it.

Thanks to BREATHER we are prepared: there will be (maybe) failures in ANRS-4D. If that's the case, well, we analyze them, that's it...

Whether with 4/7 or 5/7, or alternatively mono Tivicay ®, it will start to make numbers: we will have a large number of patients, and subsequently, the follow-up is obvious.

The poster THPEB063, by Truchis et al, will be presented on July 19 at the AIDS2016 conference in Durban;

The conference program commands: results are embargoed until 19/07 at 10:00 (local time).

As for Brexit, attentive patients will spend a sleepless night waiting for the results. We expect, of course, a statement by the authors and why not an official announcement on TV.
What you need to know before the killjoys get involved.
1- In any multicentre trial, there are failures: no known exception (Even sofosbuvir, great molecule, has had failures ...)
So there will surely be failures, this comes with the territory.
2- Thresholds for assessing who wins:
- For a test with a hundred patients, the statistical methodology is that beyond 12% difference with the comparator arm, this is not good ... The FDA is trying to reduce this to 8 %.
- In BREATHER, the comparator arm 7/7, wh had 7 failures per 100 patients (7%) and 6% in the 5/7 arm.

Twitter addicts, keep an eye on the virological failure rate with this approximate grid at hand:
- Less than 5 failures: this will be better than BREATHER: Victory and CHAMPAGNE
- 6-12 failures: this is on the right side of the handle, but the enemy is not defeated
- Beyond 12: Berezina

Let us not be fooled! Two camps clash:
- The septists (infected by the 7/7 dogma)
- Proponents of the viral window
In the camp of the proponents of the viral window (including de Truchis, Perronne, Phillibert, Liotier, and a very few, ans also Dybul ?, Anthony Faucy) Dr. J. Leibowitch and some allies.

In the Septists side: ALL other, the infamous Parisian virology clique, Molina, Goshn, Rouzioux, Katlama, Delfraissy and other frauds (neutral, thus not neutral ...): Dr. Gilles Pialoux, etc. And the rest of the world !!! Countless!

Note: the pharmacokinetics supporters (Dr. Cal Cohen, K. Butler) will know if they are right or wrong ... ...

At stake? Hundreds of millions of euros, billions worldwide, and a paradigm shift, as a key holder.

More than the result, I am looking forward to commentators: I will be among them, in the perspective of mine, that of the victim of overmedication.

Whatever the outcome, ANRS procrastination is reprehensible.

Remember to follow your usual specialized media, and, as usual, especially note those who will remain silent!

The verdict of the confrontation, is in Durban, South Africa, and the announcement, in Paris ...

Check the Internet!


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

Once a year prescription

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

Annual prescription ... Finally !!!
By Charles Edouard!

This entry pertains to the pescription rules in France. Things may be very different where you live
From a clearly lost patient ...

Doctors are paid per visit, so visits have a tendency to be multiplied.
In the video below, read at the 44:30 (Pr Even sequence is also interesting).
Prof. Grimaldi speaks at Minute 45:00 www.youtube.com/watch?v=Gx3CL-zTTnk
Pr. Grimaldi explains the mechanism, for chronic diseases: "at the Hospital we are forced to increase activity".

En route for a 12 months prescription

Now that I am at MiniDolu, is here anything better I can hope for?

This is what bothers me:
- No prescription for higher frequency Viral Loads
- Pharmacy Rx is valid for only six months

This last point is not too annoying ... Under MiniDolu six months of stock = 2 years of treatment.

But I still have go to the doctor for otherthings every 6 months, etc. etc. The pharmacist explained me that the drugs are regulated, yet, can be prescribed for 12 months. If the doctor says it's only 6 months for technical and administrative reasons: this is not true. This is 12 months [in France...]. If the physician decides so, he/she must write 'valid 12 months' or 'repeat 11 times'. "

It's the same for biology Rx: they are valid for 6 months, unless the physician specifies a longer validity (which may not exceed 12 months). That is worth knowing!

Since there was room for progress: let's go! With the following objectives:

- Get a prescription for higher frequency Viral Loads (for 12 months)
- Get a pharmacy Rx valid for 12 months

The substitute Dr and the 'Protocol'

No appointment with my specialist in a suitable time frame: I accept the substitute Doctor.

I start head-on for her opinion concerning Dual Therapy ... And here comes the teddy-bear-throwing temper-tantrum:


What preliminary and insurmountable 'protocol' is she talking about? ...

We will never know ... She looks furiously against, but now ... meanwhile, she sees that my doctor has already prescribed, dual therapy with Tivicay ®. Strained silence ...

undetectable VL , everything else OK ...

First round knockout: frequent VL = OK

But I take the leap: noone ever ever told me about the 'protocol'.

Then, I know I'll win the game: There is no such thing as the so-called protocol ... I put the frequent VL back to the table. Isn't it abnormal that I can't do frequent VL?



Let's cool down, she takes her motherly tone, especially as I show big concern. But here comes the catch, as you will see ...

I won the script for regular VL tests, valid for 1 year: it is written, I make sure it written ...

Kapitulation! Kapitulation! Rx valid for 1 year

You go to the Doctor with personnal ideas, but FRAU DOKTOR writes the script!

Berlin, August 30, 1945, the enemy is in ruins; he does not lose faith ... (Warning: German humor ...)

The door is open: small talk, cool down, she resumes her motherly castrating style, I let her go at it, I cajole, she coos: it would be ideal to also have a pharmacy script for 12 months, as this expands to next year and visit her next year, and I suggest that I will continue with her ...)

There, she understands that I know that she can write the script for 12 months: she capitulates!

So here I am with my all new script meds 12 months: Tivicay ® + Lamivudine

And with the 1/4 Tivicay regime (Minidolu), the next time is ... in 4 years ... Well... I will have to come for the biological monitoring script. (Once Minidolu is validated this will be eased also ...)

During the holidays: More Results of curent trials

While you wil be on vacation, there will be much activity with trial results:
- BREATHER has just been published
- ANRS-4D: That's very soon: September 15 CRIPS will hold a PUBLIC meeting on 4D results (more info soon)
- Katlama EACS-2015 is also published. Publication in line with what I have already presented
- Tivicay Mono as first treatment: I have already published. We also expect more results from Salpêtrière
- DOMONO (Mono Tivicay® as maintenance): results are scheduled for October

Happy holidays 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.

It's Achille's, Stupid!

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

I found this rather funny:

I love this shortcut: my doctor preferred not to play the sorcerer's apprentice: he added Edurant® .... Contemplating the result: Bravo! What did I not hear about the risk of alleviated treatments. As if adding more (or maintaining too high, it's the same ....) was safer !!! Physicians should take decisions together with patients, after explaining risks. But in practice, does the patient (or doctor) really understands what is at stake?

It is Achilles, stupid!

There are only 2 possibilities: either the risk is random, indiscriminate, or it is unevenly distributed, highest in one group, and therefore, lower or nihil in another.

It is in the best interest of Big Pharma and its relays to make believe that the risk is high and indiscriminate. This does not resist the accounting of known, documented and registered cases.

This is why we can not find anywhere this comprehensive, yet simple, accounting. It is described here: The Achilles heel.

If the risk is random: four failures out of 61 (33 + 28 Barcelona + Paris): 6.5%: it is not high ...

If it is not-random, it is based on risk categories: here, everyone speculates (without any evidence) one says the 'reservoir', this other the 'CD4 count', this one the 'Nadir', that one 'the dose'. Dr. Jacques Leibowitch proves that this is all bullshit. What about C. Katlama's presentation, which provides us very kindly, these parameters, including the historical presence of Achilles' heel? Let's fill the confusion tables, and see which one is the most relevant.

Let's build the confusion table ...

Everyone expresses an opinion on the conditions required before attempting dosage reduction. Most times, this is not consistent with the evidence from clinical trials. For example: make of a good immune reconstitution a necessary requirement: then one comes up with a threshold of CD4 = 350, another 500, another says 800, and why not 2000 while you are at it?

Let fill the confusion table for the criteria 'good restoration' with a threshold of 624 CD4 count (for that is the median, published by C. Katlama EACS-2015, in her trial patient pool).

Is a criterion of good immune reconstitution, before switching to maintenance monotherapy with Tivicay®, effective? NO!

Proponents of this (false) criterion would have excluded half of patients (14), barred, unduly, 13 patients fromt from this strategy beneficial to the patient; They would not have prevented 2 of the 3 failures!

To have a 'criterion' sensitive enough, they should have set the bar at CD4 = 1200; ie virtually exclude everyone! Exclude everyone from a strategy that works for more than 93%: what are they thinking ?!

Well... Who knows of our Parisian virologists will not be surprised.

Fortunately, Pr. C. Katlama saves our face despite this incompetent clique:

The criterion 'Achilles heel' has a sensitivity of 100%.

The criterion 'Achilles heel' has a 100% sensitivity (accounting source C. Katlama EACS-2015)

There is room for improvment, since specificity is only 60%. If we follow blindly this criterion, we unnecessarily exclude 10 of 13 patients, i.e. 75-80%.

Nevertheless, when we put side by side the tables for the (bad) 'criterion' reconstitution and the (good) criterion 'Achilles heel': there is no much room for discussion!

Paraphrasing the famous 'it's the economy, stupid !', and despite being a modestly specific criterion: it is the Achilles heel, stupid !

As for bystanders, leave them to their useless speculations, which are as many superstitions.

Science is the poetry of reality. (Richard Dawkins)

Upcoming posts: How to get a script for 1 year, why avoid the TruLight trial, how to wean antidepressants, dose-reducing doctors ...

Do not hesitate to leave your comments and questions...

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.

Minidolu

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

From one of our regular readers, following our post : Exclusive!

Well reasoned! We are getting there, we are getting there ... Elsewhere, you had never heard of the Achilles heel, HypoDolu, dose reduction by the WHO, Tivicay® monotherapy in First Line, etc. You have never heard of the snowman-melting. Here, we are getting there, and, why not as early as... today!

MiniDolu: dolutegravir 12 mg: 1/4 of a Tivicay ® pill, daily

For about a year, I keep saying that there are only two questions to ask oneself:

1 - Is Tivicay ® monotherapy possible ? and if so, 2 - For maintenance, is 10 mg just as good as 50 mg?

I have validated Hypodolu, once-weekly Tivicay ®, so, the first question, for me, is history: it's in the pocket! (Especially since I was not at risk of the so-called Achilles heel).

For Hypodolu, one question remains: Which dose? As we have no specific guide, and as I can stand it very well, I had opted for 4 pills at one time: so 200 mg: 4 tablets every Sunday.

HypoDolu: makes me very happy! It is so easy! And equally as good as ICCARRE 1/7 (with 4 molecules).

But then, in the meantime, something else happened to me, and I have to take a daily pill for another pathology: 1 daily tablet anyway. Damn ... Before, my weekly Tivicay® was my only constraint. But life is life ...

All the same, only the second question remains :

1 - Tivicay ® monotherapy: is it possible? 2 - For maintenance, is 10 mg as good as 50 mg?

Well, there you go:

So after my analytical interruption (to know my time to rebound ...), I resuppressed the virus with Tivicay® 7/7 50 mg for 15 days. The rebound, which was the whole purpose of the measurement, was very low, so after 15 days, I was undetectable, as usual.

I started with 1/2 of a pill (25 mg) and did a quick validation, then, I moved to 1/4 of a pill, daily.

I put it in a gel-cap along with the other medication I have to take, some sort of 'home-made' co-formulation, and here I am, with my daily intake of the other medication without any visible HIV treatment: 0 intake!

(Let's be honest, the 1/4 Tivicay® pill is hidden in the gel-cap ...)

But still ... it becomes completely invisible.

And a daily 1/4 of a pill amounts to 87.5 mg / week: can't beat that!

And, here I am, with my second VL, under this new strategy, and, still undetectable!

Already three months of experience; I'll just wait 6-9 months and my new baby comes! And since CD4 (1000) and CD4/CD8 ratio (close to 2) are stable, I have no fear ...

Until then, I have lots of new and exciting things

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.

Exclusive

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

I pruned a bit (sorry ...), but this is the spirit:


If you think you or your doctor know how to talk to the virus, you live in delusion: The virus is deaf. Yet, with a good molecule (finally !...) and a good method, it is 'defeated'. The method is conceived from the accumulated evidence and those coming. Opinions, feelings that ignore the evidence are superstition! Don't be afraid ...!

The first line with Tivicay® monotherapy: Exclusive news

This post follows our post on "Tivicay ® monotherapy as induction", where I announced what was foreseeable: Tivicay ® monotherapy as first treatment.

Do not confuse these monotherapy results with maintenance monotherapy (clinical trial: DOMONO) which results are expected late 2016: Congress on HIV Therapy (Glasgow 2016), because of delays in recruitment.

Since the induction monotherapy is for treatment-naïve patients, they do not have the Achille's heel. And all those, who do not have the Achille's heel, are in fact naïve to first generation INSTIs (Isentress® or Stribild® / Genvoya®).

The results are published: this is therefore not, strictly speaking, an exclusive. But since no one has noticed this crucial information, well ... yes ... You hear about it for the first time, here.

Just as you had never heard of Achilles or WHO's approval of Efavirenz 400 mg, it is time to ask yourself some questions about your favorite media!

Lanzafame: the frontrunner!

Dott. Massimiliano Lanzafame?? He is no stranger to us. He appears in this post: "WHO proves us right !". He is to Italy what Leibowitch is to France. His method is a little different, though: he reduces a dose, without any pre-requisite on reservoir, CD4 count, etc. (these prerequisite belong to the 'Parisian', subsidized, bullshit), and demonstrates that efavirenz reduced to 400mg, or nevirapine, reduced to 200 mg, just works as well. No other prerequisite than having undetectable Viral Load for 1 year. Same with Protease Inhibitors.

This is less ambitious than Dr. Leibowitch but Dr. Lanzafame has managed a get his recipe, albeit modest, throught the yoke of international trials and reach, without any reservation, its approval by the WHO. Neither Leibowitch (with his wonderful ICCARRE) nor Katlama (with her shaddy PI monotherapy) ever got even close.

He works in a small hospital (Verona ... That's no New York), so has only few patients: he has good insights, good methods, just a smaller army ! Who cares ? ... Besides we love his way of asking, falsely naively, questions that are of prime importance: If maintenance works with a half dose, then, what use are those famed blood dosage for ? What is it? If not pure bullshit ... I just love it!

Of course, among the small, Peytavin-fed, Parisian clique, he is not popular. But with patients, this working very well. And, let's add, the validation of his Efavirenz 400mg by the WHO (following the ENCORE-1 trial), is really a major success!

So, off he goes, as we did here, with the results of the clinical trial ING 111521, which I commented here.

This trial showed that 90% of patients reach the 400 copies beacon (the final leg to undetectability) in less than 10 days!

Then he will repeat the ING 111521 trial (which dates back to 2008! ...), but, without interrupting at day 10. Same as ING 111521, he goes with 9 patients. The trial ING 111521 protocol required to stop the mono-therapy at day 10 : this time he just goes as far as undetectability... and, obviously, if the VL becomes undetectable, he carries on. There is no reason to stop.

A bit like Dr. Lafeuillade, whose patient by himself, in first line, in primary infection, started with mono Tivicay ® ... and it worked, so why change his regimen.

In my humble opinion, he scored earlier than Salpetriere (a Parisian Hospital)... Blame it on Voltaire, if you want: they'd better move their ass a little faster.

So, our Lanzafame started with 9 patients for first line Tivicay ® monotherapy.

This is far from well greased, slow collusion of our North American clinicians. But where are those Canadians, who had pinpointed the great surprise of the test ING 111521 first ? Not to mention, of course, Dolutegravir's inventors. Here, it is easier to understand: it's a big business. But Canadians? Disqualified, despite having had the pole position?

There you go. It is published here:
http://www.ncbi.nlm.nih.gov/pubmed/27097366
Dolutegravir Monotherapy in HIV-Infected Patients With Naive <100,000 copies / mL HIV RNA Load. It's from Lanzafame (so it's good ... see his résumé); this is with 9 patients, and I will publish the results in a coming post: it's great!

Say, there are only two questions to ask oneself:

1 - is Tivicay ® monotherapy possible, and if so... 2 - for maintenance, is 10 mg as good as 50 mg?

Soon there will be only one left: the second ...

Next posts: Why avoid the TruLight trial, how to wean antidepressants, Yes, This is Achille's !, best doctors ...

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.