I began treatment a year ago with Combivir/Kaletra and did very well, with my TCell count rising from 200 to 429, and my viral load dropping from 322,000 to undetectable. I developed lactic acidosis and my Dr. took me off all meds for 2 months. He prescribed Truvada/Kaletra which I began 8 days ago. I am beginning to feel discomfort in my upper stomach/liver area again, which I had during the earlier treatment, and a very mild rash on the lower side of my forearms. I have had Hep A and B before I became HIV+, and am otherwise in excellent health.

The risk for lactic acidosis with Truvada (tenofovir + FTC) is likley less than with Combivir (AZT + 3TC) since Truvada lacks a thymidine analogue. There is actually more data on the use of abacavir substituted for AZT with generally good outcomes though your prior experience with lactic acidosis suggests a pre-disposition so careful follow-up is recommended. The symptoms you describe are non-specific so laboratory and direct clincial evaluation by your HIV specialist is recommended. KH