Nucleoside analogue-induced fatal lactic acidosis in two HIV-infected patients in Singapore.
The introduction of antiretroviral therapy has led to a significant decrease in the mortality and morbidity associated with human immunodeficiency virus (HIV) infection. Nucleoside reverse transcriptase inhibitors (NRTI) have been widely used as part of the antiretroviral therapy against HIV. However, one recently recognised serious complication of NRTI is the development of lactic acidosis. We report two cases of fatal NRTI-induced lactic acidosis, which occurred within five months of each other. Both were being treated with didanosine (ddI) and stavudine (d4T). Physicians involved in the care of HIV patients should recognise and be alert to the possibility of this highly fatal complication.
Hwang
S W
SW
Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore.
Leo
Y S
YS
D000140:Acidosis, Lactic / Q000139:chemically induced*; D000328:Adult; D016049:Didanosine / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D018119:Stavudine / Q000009:adverse effects* / Q000627:therapeutic use
D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine; D016049:Didanosine