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persistent diarrhea
Jun 18, 2007

I have been HIV+ since 11/98 and according to my provider I am asymptomatic eventhough my current CD4 count is 556 and the VL is undetectable. Since around 9/06 I have had diarrhea 4-6 a day and sinusitis and I don't understand why my provider classifies me as asymptomatic and has been unwilling to change my HIV meds of combivir and Sustiva. I am finding it hard to deal with these two conditions which I never had before and I do not know what to do. I feel that I should stop my meds for the HIV until I can find another Health Facility that can help me.

Tomas

Response from Dr. Daar

Thank you for your post. I am very sorry that you are having these difficulties. I suspect that the reason your provider is reluctant to make a change in your antiretroviral is that it would seem to be very unlikely that your medications are causing your current complaints. While no one can exclude the possibility that HIV is contributing to your diarrhea and sinusitis it would seem unlikely in light of your high CD4 cells and undetectable viral load. Moreover, it seems unlikely that even if the symptoms are related to HIV changing medications would make a difference.

I know it is very frustrating not having an answer but I do think it is important that you be thoroughly evaluated for causes of diarrhea. This would include stool studies and possibly even an evaluation by a gastroenteritis. Similarly you need to make sure your sinusitis is completely treated and you are evaluated for common causes of recurrent sinusitis. Again, at times a specialist such as an Ear Nose and Throat doctor may be of some help.

I think the above should be your highest priorities. That said, if you still want to consider a change in antiretroviral therapy I would encourage you to have a heart to heart with your provider.

Best, Eric


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