Answered by:
Stuart D. Federman, PharmD, AAHIVP
Gateway Apothecary
Saint Louis, MO


Celiac disease affects 1 in 100 people worldwide. Currently, the only treatment for celiac disease is a gluten-free diet. Gluten, a protein found in wheat, barley and rye, causes an autoimmune response in the body that causes the body to attack the folds of the small intestine, which are essential for absorption of food and medications. Since HIV medication is essential to managing the disease, it’s important to adhere strictly to a gluten-free diet to gain the most benefit from the medication.

Diarrhea is a common symptom of uncontrolled celiac disease. Patients with diarrhea commonly present with dehydration and can lose many vital nutrients and electrolytes. Try to drink plenty of water to replace lost fluids, and keep a well-balanced diet in order to ensure that nutrients are replaced. Celiac disease does not cause any issues with the results of an HIV test and celiac disease has not been shown to affect the absorption of any of the antiretroviral medications.

Some HIV medications cause side effects that mimic the symptoms of celiac disease. These are older HIV medications, such as zidovudine and didanosine, which are commonly known to have side effects including nausea, vomiting and diarrhea. These medications might cause confusion as to whether these symptoms are due to the medication or celiac disease.

In patients with heartburn or reflux, sometimes proton pump inhibitors such as omeprazole are used as treatment. These medications decrease the amount of acid in the stomach, which prevents the medication from being absorbed. Patients who are taking Complera or Reyataz should not be taking these medications together with proton pump inhibitors, since they require an acidic stomach environment in order to be properly absorbed.

Additional writing by Mason Stewart, student pharmacist at the St. Louis College of Pharmacy.