Fatal portal hypertension, liver failure, and mitochondrial dysfunction after HIV-1 nucleoside analogue-induced hepatitis and lactic acidaemia.
Acute hepatitis with lactic acidosis is a life-threatening but reversible toxic effect on mitochondria of HIV-1 nucleoside-analogue treatment. We report fatal portal hypertension, liver failure, and persistent mitochondrial dysfunction in a man aged 65 years with HIV-1 infection who had recovered from nucleoside-analogue-induced acute hepatitis and lactic acidaemia more than 18 months previously. We believe that symptom free patients who receive nucleoside-analogue therapy should have hepatic function constantly monitored, especially those with past or present lactic acidaemia.
Carr
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HIV, Immunology, and Infectious Disease Clinical Services Unit 2010, Sydney, Australia. acarr@stvincents.com.au
Morey
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Mallon
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Williams
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Thorburn
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DR
D000208:Acute Disease; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications / Q000473:pathology*; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D005234:Fatty Liver / Q000473:pathology; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D006975:Hypertension, Portal / Q000139:chemically induced* / Q000150:complications; D008297:Male; D008930:Mitochondria, Liver / Q000187:drug effects*; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine; D018119:Stavudine; D016049:Didanosine