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Ask the Experts about Managing Side Effects of HIV Treatment
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PI diarrhea
Nov 23, 2008

Started boosted lexiva,truvada in March, now UD and good CD4/and percents

Dentist put me on clindamycin for what he thought was an infected tooth in May (it wasn't)with immediate diarrhea, tolerable so I completed the regimin.

Had continuous diarrhea even after the clindamycin d/c'd. Normal c diff test but ask my provider if I could take flagyl anyway. Still have weekley sometimes daily bouts of diarrhea so figured it was actually the PI. But if I take a daily probiotic tab, it seems to stop. If that's the case it can't be the PI right? PI's don't mess up colonic flora, correct?

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   Response from Dr. Henry

Clindamycin can cause problems with C difficle infection-were you checked for that? Protease inhibitors can cause chronic loose stools in some px which are variably helped by treatments including fiber supplements, calcium supplements, probiotics or yogurt supplements, or antidiarrheal meds. The mechanism of protease inhibitor related loose stools is not clear to me but often related to the ritonavir used as a booster which simply seems to irritate the gut of some patients. KH



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