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Question about malabsorbtion of nutrients.

Apr 1, 2010

Hi Nelson,

I have been HIV positive for 6 years and on no medication currently. CD4's are around 701 and viral load goes between 1000 and undetectable.

Was doing fine and then had a period where the lymph nodes in my neck swelled up and after that I started noticing thinning in face and my legs started aching and thinning.

Now my stools are very large and usually dehydrated as if something has happened to my ability to absorb at the intestinal level.

I have bought Frutein and some other powder shake drinks, also drinks like Ensure and Boost.

If the cause of this is infection by HIV in my gut or intestine wall, what is the treatment for this? Do you have to try to take a drug that flushes out the HIV from those locations? Do ARV's acheive this, or do they only work for virus in the blood.

Kind of depressed as everything was fine until this apparent spread of the virus.

Have contacted a gastroenterologist to check for viral or bacterial infections that might also be causing issues.



Response from Mr. Vergel

Very good question.

Most of us have have gut problems. Your description of your stool does not sound too bad to me. Large stools that seem dry? I wish I had those. Most of us long term survivors have soft stools and sporadic diarrhea. Some of these issues may be related to medications and some may be related to inflammation of the gut mucosa. We have found that HIv depletes CD4 cells in the gut-associated lymphatic tissue (GALT). Other studies show that we may have immune activation caused by substances that leak from our guts into our blood stream. HIV meds seem to improve this but not normalize it. There are researchers looking at this right now.

You have a very good immune system and I assume you still have undetectable viral load, so I would not be too concerned.

One of the supplements that has been studied for gut integrity is glutamine, a powder that you can buy in health food stores or online. Doses of 15 grams a day seem to be improving people's gut function. Also, soluble fiber from oranges, apples, and oat meal, and greek style yougurt may restore good flora and health in many.


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