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Jan 4, 2009


Hi Doc BY,

I've been experiencing diarrhea for months now after my ART, although my stool test are normal, and I dont feel weak or fatigue. My bowel movement are 5 times a day. Is there something wrong or should I worry? By the way I am on tenofovir+efavirenz+lamivudine (3 months now) and CD4 (143)

Thanks a lot

Response from Dr. Young

Greetings back at ya!

Thanks for your post.

Unless you had 5 stools per day when you were healthy, I'd think that having to go 5 times a day would seriously impede daily activities.

If your stool tests were all normal, one would have to conclude that this is a side effect of one of your three medications. Which one? Hard to be sure, though I've had some patients report diarrhea from their tenofovir (it's also possible that one of the others could be too).

One could try holding the tenofovir for a day to see if your bowels improve, if not, then try holding the lamivudine. If one of these is the culprit, a switch to an alternative HIV medication should definitely help.

What's key to me is that while this regimen is very well tolerated for most people, your not most people, you're you. My goal for treatment is that my patients are able to live entirely normal lives and life-spans. Five stools a day for the rest of your live isn't part of that plan.

I hope this helps,


re timing of doses

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