Hi Dr Moyle,

Was just after a second opinion after you last answered my questions for me. I had stayed on my current first line treatment of Prezista 900mg Truvada and Norvir, but was not feeling well as I discussed with you in July. I went to my GP complaining of upper right abodomen pain ( a very uncomfortable ache) he first did a urine test and there was a slight infection there so he prescibed Trimithoprim, I was given some painkillers but the pain was getting worse and I felt no better after the antiobiotics so I was put on Cefelexin and given Tramodol these did not keep the pain away, so in the end I was given Oramorph. I have just had an scan of my abdomen had been waiting over 4wks for it showed nothing that could be causing the pain. When the pain gets bad I get pain between my shoulders also, and feeling sick. I went to my HIV clinic today and I have been asked to go on a trial of just Kaletra 2 tablets twice a day for a month. This is a study to see if I wont become resitent to the current regime Im taking. So as of tonight no more Prezista Norvir or truvada. And I am hoping this is going to stop this pain I have been having in my abdomen (upper right) although I am not sure I think it could be my meds. Do you think I am putting my health at risk going on this study. My current cd4 is 1079 and viral load is undetectable. Thanks again best wishes A

Hi A It certainly sounds as if you need this pain investigated with blood tests and scans like an ultrasound as a matter of urgency. Not just giving stronger and stronger pain killers. In general, if you are unwell you should not be participating in clinical trials. Use of Kaletra as monotherapy has been extensively investigated in modest size clinical trials. It works OK for most people but more people get blips in viral load, a possible sign of future viral rebound and resistance. I'm not sure why you keep receiving therapies which are not approved or recommended in international guidelines but thankfully your results are good. Kind Regards Dr Moyle