Very interesting. As a biochemist specialised in the microbial interactions "microbial ecology", quite a lot is being studied concerning gas formation in the gut, the role that certain types of bacteria play in the GI-tract, what distrubances lead to, .... The use of pre/probiotics (probiotics: bacteria that have a beneficial effect on the composition of the GI bacterial flora, prebiotics: chemical compounds such as inuline that favor the growth of probiotic bacteria) can certainly help there, as is proven by several studies. As far as i know (i don't read medical articles that often) there have been no/few studies to determine the effect of HAART on the GI flora. It might be considered for further research, that side effects need not necessarily be interactions between patient/meds, but also between GI flora and meds. As quite a few meds are degraded by bacterial cytochromes and cometabolic processes, this is not far-fetched at all. I'm not on HAART now (CD4 at 560/26%, VL 4,4K) but my partner is on PEP since a condom rupture a week ago. I've been giving him a pre/probiotic commercially available mixture of lactic acid/bacillus thermophilus/... m.o.'s and so far the combivir + nelfinavir (notoriously known for GI trouble) have shown... no side effects at all. Dr's, if interested, let me know, i'd be happy to exchange thoughts on this.

Your thoughts on the topic of HIV therapy and the gut/gut flora are interesting and appreciated.