title: [Hepatic steatosis during treatment with zidovudine and lamivudine in an HIV-positive patient].
abstract: A 33-year-old HIV-infected man was given antiretroviral therapy with zidovudine and lamivudine. After ten months' treatment the patient had elevated hepatic transaminase levels. Severe hepatic steatosis was found in the biopsy. Clinical history, laboratory, microbiologic and X-ray examination revealed no other abnormalities. The transaminase levels remained high after withdrawal of zidovudine alone, but a decrease was observed when both zidovudine and lamivudine were stopped. Rechallenge of lamivudine therapy caused the levels to increase again. The hepatic steatosis was considered to be caused by the antiretroviral therapy, lamivudine having a synergistic influence on this side effect of zidovudine. Ten months after the therapy was changed to the protease inhibitor indinavir combined with zalcitabine and stavudine, two other nucleoside analogues, hepatic steatosis recurred.
authors.affiliation: Afd. Algemeen Inwendige Geneeskunde, Academisch Ziekenhuis, Nijmegen.
authors.forename: H J
authors.initials: HJ
authors.lastname: ter Hofstede
authors.forename: P P
authors.initials: PP
authors.lastname: Koopmans
authors.forename: U J
authors.initials: UJ
authors.lastname: van Haelst
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000139:chemically induced* / Q000201:enzymology / Q000473:pathology; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects*; D008297:Male; D000637:Transaminases / Q000097:blood; D015215:Zidovudine / Q000009:adverse effects*
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine; D000637:Transaminases