Clinical features and risk factors of lactic acidosis following long-term antiretroviral therapy: 4 fatal cases
| Autor: | H.J.M. ter Hofstede, S. de Marie, N.A. Foudraine, Kees Brinkman, Sven A. Danner |
|---|---|
| Přispěvatelé: | Internal medicine, Medical Microbiology & Infectious Diseases |
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Anti-HIV Agents HIV Infections Dermatology Gastroenterology Fatal Outcome Risk Factors immune system diseases Internal medicine Antiretroviral Therapy Highly Active medicine Humans Pharmacology (medical) Didanosine Acidosis Reverse-transcriptase inhibitor business.industry Stavudine Public Health Environmental and Occupational Health Lamivudine virus diseases medicine.disease Virology Mitochondrial toxicity Infectious Diseases Lactic acidosis Vomiting Reverse Transcriptase Inhibitors Acidosis Lactic Female medicine.symptom business medicine.drug |
| Zdroj: | International Journal of STD and AIDS, 11(9), 611-616. SAGE Publications Ltd International Journal of Std & Aids, 11, 611-616. SAGE Publications Ltd Hofstede, H J M T, De Marie, S, Foudraine, N A, Danner, S A & Brinkman, K 2000, ' Clinical features and risk factors of lactic acidosis following long-term antiretroviral therapy : 4 Fatal cases ', International Journal of STD and AIDS, vol. 11, no. 9, pp. 611-616 . https://doi.org/10.1258/0956462001916498 |
| ISSN: | 1758-1052 0956-4624 |
| DOI: | 10.1258/0956462001916498 |
| Popis: | Our objective was to describe clinical features and predisposing factors attributed to lactic acidosis in 4 HIV-infected patients on long-term nucleoside reverse transcriptase inhibitor (NRTI) therapy. All patients had received at least 6–20 months of NRTI-containing antiretroviral therapy: all used stavudine (d4T), in one combined with lamivudine (3TC), in the other 3 with didanosine (ddI); in one hydroxyurea was added. In all, the initial symptoms were gastrointestinal (nausea and vomiting), followed by tachypnoea preceding the lactic acidosis; death followed 6–22 days after admission (liver failure and uncontrollable arrhythmias). Treatment with riboflavin was unsuccessful in one patient. The only definite risk factor in all cases was NRTI-induced mitochondrial toxicity; one patient was concomitantly treated for Kaposi's sarcoma (with bleomycin and vinblastine) and one just recovered from pneumococcal sepsis. None of the patients had a history of chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. In all patients, some sort of toxicity to other previously used NRTIs had occurred earlier. Lactic acidosis occurred after months of NRTI therapy in patients who had already suffered other forms of NRTI toxicity. Concomitant diseases or comedication might have aggravated the mitochondrial toxicity of the NRTIs. Screening methods to detect mitochondrial toxicity are necessary, since lactic acidosis occurs rather unexpectedly, with a rapid, fatal course. |
| Databáze: | OpenAIRE |
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