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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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GI side effect
Jan 16, 2008

I was on Kaletra/Truvada for about two years with persistent GI side effects (mostly diarrhea, but gas and cramps as well). I stayed on this combo because I was in a study. I developed coping strategies, mostly keeping an extra set of clothes in case of the unexpected "crapping my pants". This occured about one to two times a month. However, diarrhea was present 3-5 days/wk with 3-5 episodes/day of diarrhea. My physician recently switched me to Lexiva/Truvada/Norvir in hopes of reducing the problem. It did not make much difference, and the cramping/gas was probably worse. I am suspicious that Norvir is the issue and am hesitant to try the next step of Reyataz/Truvada/Norvir. At this point, I am considering going back to Kaletra/Truvada and continuing the coping strategies from before.

Response from Dr. Henry

The tenofovir in Truvada can also contribute to gut symptoms in some patients. Have you tried abacavir instead of tenofovir (if HLA B5701 negative) often substituting Epzicom for Truvada? When Epzicom is used with atazanavir then the use of ritonavir is not necessarily required so the ritonavir can sometimes be dropped (increasing the atazanavir dose to 400 mg/day) if one is doing well (suppressed virus with not much resistance) on Epzicom/ritonavir/atazanavir. KH

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