I have been on Atripla for a year now, after changing from another regime which caused bad cramps when eating food or during the night when asleep - after all the tests such as cameras, ultra sounds etc it was decided it was more than likely my meds causing the problems which was also causing IBS symptoms so I switched...

... Since then the issues with cramps have reduced significantly, however not fully disappeared and the odd bout of IBS still occurs but this is more so if life is a bit stressful at the time or I feel a little low (which happens sometimes) or worry.

Since switching meds however I have noticed that my stomach seems a little fatter, although my weight has stabled - after putting on 8lbs since the switch.

Recently I noticed a lump in my breast (Im Male) and showed my consultant when I was last in, they said they were confident it wasnt anything to worry about and could be a fatty lump caused by meds - since my last appointment the lump has shrunk slightly but still makes my breast tender to touch - I worry that there is something wrong with me which and cant stop thinking the worst, which doesnt help with my stress levels or IBS.

Is it normal for patients on Atripla or other meds to experience random lumps and do most of these disappear over time or would you suggest maybe getting it removed?

Gyncecomastia is seen in HIV+ persons and perhaps (though not clear in my mind) more often in persons on antiretroviral medications. Gynecomastia has been reported though infrequently (< 5%) in patients taking Atripla. Many other factors including other drugs, alcohol or pot use, steroid use, endocrine disorders, renal and liver disease and many other conditions can contribute. Most often, however, a full work up doesn't find one likely cause. On top of that the course of gynecomastia (most often increased fatty tissue) is highly variable with many cases enlarging and then shrinking over time with no intervention. Thus, good long term data are lacking. I have seen dozens of HIV+ men with gynecomastia over the years and only a small handful underwent surgical removal of fatty tissue. In most cases diet, exercise, and more time resulted in stabilization or decrease of the fatty tissue. KH