HIV enteropathy treatment

Question

I am 54 years old and have been HIV+ for over 20 years. Current regimine is norvir, lexiva, truvada. Viral load undectable, T cells 700+. Last couple of months have experienced daily diarrhea...never really had it before. Have had stool tests for parasites, etc, blood work and colonoscopy. All negative. Dr. mentioned HIV enteropathy? Is this possible, if so is their a treatment?

Answer

HIV enteropathy is unusual in the setting of good viral control and high CD4 cell counts. Gluten enteropathy, lactose intolerance, and abnormalities in bowel flora (latter often helped by use of active culture yogurt)and many other conditions can cause chronic diarrhea. Protease inhibitors in some patients (particularly ritonavir) can cause chronic annoying loose stools which can sometimes be managed with a variety of interventions (anti motility agens, bulking/fiber, calcium supplements, yogurt). KH