red flag or normal side effect?
Apr 26, 2009
My partner has been on HIV meds for one year, and his CD4 has jumped from 44 up to 220. Lately, however, his diarrhea is getting worse-- to the point that it is constant and uncontrollable. On top of this, he has developed a fever. Could the severity be due to medication side effects? He is taking Combivir + Kaletra. I am writing on his behalf as he does not speak English, and because where we live does not have the greatest health care. I trust you guys here much more than the docs here... So, if you see any red flags you think I should inform the doctor of, please let me know.
Response from Dr. Henry
Some patients will continue to have annoying diarrhea from Kaletra/Combivir but many other conditions (both HIV related and unrelated) can cause diarrhea. A good GI work up would include stool analyses for a number of infections including parasites and C difficile if indicated. If no other cause is found and switching to an alternative regimen is not an option where you are located (such as Kaletra to boosted atazanavir or darunavir or to efavirenz and Combivir to Epzicom or Truvada) then treatment with an diarrheal meds, oat bran, other forms of fiber, calcium supplements, macro biotics or active culture yogurt or other interventions can be variably helpful at making the drug related diarrhea more tolerable. some patients also develop a lactose intolerance (cow milk sugar) as another consideration (also gluten sensitivity can be seen as well). KH
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