I have been on my current meds (Lexiva/Viread/Ziagen) for 2 years with undetectable viral load. Problem is that I have frequent bowel movements (up to 5x per day) with loose stool and sometimes diarrhea. While this is not entirely unmanageable it is unpleasant and often causes irritation and difficulty for me in having anal intercourse. My doctor had done two cultures to rule out parasites and now I'm on a two week drug holiday to see if the condition improves. I am about a week into this and there has been some improvement but not complete resolution. My doctor proposes switching to Atripla if there is "improvement" during the drup holiday. I have some fear about switching causing resistance to my current meds and side effects of the new medication. Is that likely? Also if I don't have complete resolution of the problem, does it make sense to switch not knowing how my body will react to Atripla?

Thank you for your post.

An important thing for you and others to know about antiretroviral therapy is that recommendations can only be made by those who have a full understanding of your past therapy, response to treatment and how well medications were tolerated. Without this information even the most expert of providers can not make good recommendations regarding treatment. Consequently, in order to provide you information regarding the likelihood of success on Atripla I would need much more information.

If after discussion with your provider it is determined that you are likely to be able to suppress your virus with Atripla then I would suggest it would probably be a safe strategy. Of course all medications can cause side effects, but diarrhea from Atripla would be unusual and other potential adverse events can certainly be monitored for.

With regards to your diarrhea, I would suggest that if it persists off of therapy you may need further evaluation, such as by a gastroenterologist since it is less likely (not impossible) that starting a new antiretroviral regimen will make it go away. If the diarrhea does go away off of therapy certainly Atripla is less likely to make it come back than your previous regimen.

I hope this helps. Best, Eric