HIV and AIDS
Ask HIV and AIDS Experts. Get Answers to Your HIV and AIDS Questions
How long have you had the diarrhea/ GI symptoms?
Did this correlate with a change in your medications?
What is your HAART/ HIV medication regimen, and do you know your CD4 count and viral load?
The Truvada is unlikely to cause your symptoms- unless you do have lactic acidosis, which is quite rare from this medication.
I would suspect your diarrhea is either from the Prezista or Norvir- which is extremely common, or from irritable bowel , or pancreatic insufficiency. You are already on pancreatic enzymes- although you have not mentioned if the enzymes improve symptoms ( compared to if you skip them). Antidiarrheals can help if it is from the protease inhibitors ( prezista/ norvir), and some people find that calcium supplements/ Tums also help in these symptoms.
I would not worry about Crohn's , given that it sounds like you have had adequate GI workup by endoscopy. And there is no strong data showing a worry about pancreatic cancer- also something that would have shown up if you have had a CT scan before. Irritable bowel is very common, and likely contributes to your symptoms- it helps to recognized what worsens it, and avoid that. Also keeping a good fiber intake helps regulate bowels.
It sounds like you are doing great with respect to HIV- while I would not advise changing your regimen, there are alternatives to protease inhibitors that have less GI side effects- especially integrase inhibitors ( raltegravir). I would leave this option as the alternative if your symptoms really are too troublesome.
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