title: Type B lactic acidosis: a rare complication of antiretroviral therapy after cardiac surgery.
abstract: This report describes a 47-year-old woman with human immunodeficiency virus (HIV) and end-stage renal disease on hemodialysis, treated with combination antiretroviral drug therapy, who developed an acute, severe type B lactic acidosis 24 hours after homograft root replacement for endocarditis. She fully recovered after HIV medication was discontinued, along with administration of riboflavin and supportive measures including hemodialysis. The timing of this complication and previous reports suggest that open heart surgery may be a risk factor for nonischemic (type B) lactic acidosis in patients taking nucleoside analogue reverse transcriptase inhibitors.
authors.affiliation: Department of Surgery and Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA. vasseubg@umdnj.edu
authors.forename: Bernard G
authors.initials: BG
authors.lastname: Vasseur
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawanishi
authors.forename: Nahir
authors.initials: N
authors.lastname: Shah
authors.forename: Mark L
authors.initials: ML
authors.lastname: Anderson
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006350:Heart Valve Prosthesis; D006801:Humans; D019469:Indinavir / Q000008:administration & dosage / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications; D019259:Lamivudine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications; D006435:Renal Dialysis; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects; D018119:Stavudine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D019469:Indinavir; D018119:Stavudine; D019438:Ritonavir