TITLE

Symptomatic Lactic Acidosis in Hospitalized Antiretroviral-Treated Patients with Human Immunodeficiency Virus Infection: A Report of 12 Cases

AUTHOR(S)

Coghlan, Michael E.; Sommadossi, Jean-Pierre; Jhala, Nirag C.; Many, Wickliffe J.; Saag, Michael S.; Johnson, Victoria A.

PUB. DATE

December 2001

SOURCE

Clinical Infectious Diseases;12/1/2001, Vol. 33 Issue 11, p1914

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

We retrospectively investigated the clinical and histopathologic features of hospitalized patients infected with human immunodeficiency virus who had symptomatic lactic acidosis syndrome at a university teaching hospital during 1995--2000. Twelve patients were identified, 11 during 1998--2000; of these, 5 died with rapid progression to otherwise unexplained multiple-organ failure. All had extensive prior exposure to nucleoside analog reverse-transcriptase inhibitors (NRTIs). At presentation, the most commonly identified NRTI component of antiretroviral regimens was stavudine plus didanosine. Eleven patients presented with abdominal pain, nausea, and/or emesis. Eight patients had prior acute weight loss (mean [SD], kg). Median venous plasma lactate levels were 12 5.3 2-fold greater than the upper limit of normal (2.1 mmol/L). Serum transaminase levels were near normal limits at presentation. Histopathologic studies confirmed hepatic macrovesicular and microvesicular steatosis in 6 patients. Concurrent chemical pancreatitis was identified in 6 patients. The increasing number of cases identified during the study period suggests that physicians better recognize symptomatic lactic acidosis and/or that cu-mulative NRTI exposure may increase the risk for this syndrome.

ACCESSION #

5532798

Tags: HIV (Viruses) -- Patients;  THERAPEUTICS

 

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