This will be a quick and short post, because I have not yet taken the time or effort to personally reach out to Dr. Jacques Leibowitch, the 72-year-old doctor in France who is advocating protocols to reduce drug toxicities for patients taking antiretroviral cocktails. The potential for his work is so important that I am sharing what I have learned so far, and providing links at the end for anyone interested in pursuing further.
The underlying premise behind Leibowitch’s work is based on the Hippocratic oath that doctors swear to “do no harm” to their patients. Leibowitch argues that leaving AIDS patients on high dose combination treatment for life, even after their viral load is under control, is harmful and that alternative protocols be considered and researched.
Because nearly all the literature is in French, I must rely on virtual translations, such as Google Translate, or help from friends who do understand both French and English.
In the simplest possible summation, Leibowitch has treated HIV-positive patients with traditional ARV cocktails, called HAART. Where he leaves the path of conventional treatment guidelines is that once a patient is “stabilised”—meaning they have achieved respectably high CD4 counts, and their viral load is undetectable for six months—Leibowitch starts reducing the number of days per week that a patient takes these drugs.
I have read that some patients have successfully reduced their dosing regimen to as little as twice, or even once per week. However, the most commonly mentioned protocol, and the one Leibowitch is agitating to have performed as a large clinical trial, is four days per week. I cannot tell whether this trial is now underway, or has only been proposed.
No doubt about it, Leibowitch is a die-hard orthodox believer in the hypothesis that HIV is the cause of AIDS. According to wikipedia, he even suggested this to both Montanier and Gallo in the earliest days of the epidemic. The doctor is known for being outspoken and “colorful”, which may help explain why he struggled so hard to get funding for trials. I have read in narratives things like “the man has always been at the margin” and is “often mocked by his “peers”.
Still, Leibowitch has documented his success with 90 patients over a period of ten years and he did present his findings at the 30 Years of HIV Science conference, held by the Pasteur Institute last year. He is also the author of Un virus étrange venu d’ailleurs (A strange virus of unknown origin) in 1984 and Pour En Finir Avec Le SIDA (Putting an end to AIDS) in 2011.
The man has creds.
Throughout the literature available online, Liebowitch repeatedly states two warnings: first, patients must be under the care and direction of a physician, and secondly that only certain ARV combinations will work with his protocol. He uses two NRTIs and either a boosted protease inhibitor or a NNRTI. Isentress and Truvada, for example, are not on Dr. Leibowitch’s list of candidates.
One could hardly expect a renowned physician to recommend otherwise. On the other hand, Leibowitch has now retired and most of us do not have access to anything close to a comparably willing doctor to advise and prescribe for us. As has been the case for 30 years, AIDS patients are still on their own to find the best possible treatment options, and we can add Leibowitch’s findings to our personal knowledge base for choices to consider.
Leibowitch’s work and findings warrant a considerably more in depth review than I have offered here, but I have been sitting on this since it was shared with me in March. I’ve read enough to recognize its importance to people looking for ways to reduce the toxicity of HAART, so I am sharing what I know now. Below are some links to additional information, all of them in French, though an English site is apparently under construction.
I am always interested in hearing from readers who are managing to reduce dosages in HAART and I welcome communication via the “Contact Me” tab at the top of every page on my blog. I treat all correspondence as confidential.