Hi doctor Henry. Here is a question (or 2) from the Netherlands. First i want to say that i appreciate this website so much. I am on atripla now for about 3 years (first truvada and stocrin) and i am undetectable with about 800 t-cells. Before the atripla i used Kaletra and Kivexa. I changed this combination because taking pills once a day was easier. After 3 years using this combination it seems that my kidneys are protesting a little bit and my doctor told me that i possibly have to change my combination. My two questions are: Will my bloodresults concerning my kidneys become normal again after stopping atripla? My second question is what you would suggest as another combination wich i can take once a day, if possible without a lot of food restrictions? (I was thinking about Stocrin and Kivexa but maybe there is a better solution) Kindly regards, John

The recommendation about what to do depends partly on details about what the kidney problem is. In the US much of the kidney problems in HIV+ persons relate to HIV nephropathy which is seen mostly in African Americans and is characterized by protein in the urine and then progressive renal dysfunction. High blood pressure, diabetes, other drugs (such as ibuprofen) can contribute to renal problems. If tenofovir (in the Truvada) appears to be contributing to the renal dysfunction then a switch is recommended. Kaletra + Kivexa (abacavir + 3TC) can be dosed once a day as can a number of other boosted PI based regimens. If the renal dysfunction is severe then a dose adjustment for the lamivudine needs to be made. KH