Bench-to-bedside review: severe lactic acidosis in HIV patients treated with nucleoside analogue reverse transcriptase inhibitors.
Nucleoside reverse transcriptase inhibitors (NRTIs) are effective antiretroviral therapy for the treatment of HIV-infected patients. NRTIs can induce mitochondrial impairment that leads to a number of adverse events, including symptomatic lactic acidosis. In the present review, we describe the underlying mechanism of NRTI-induced toxicity and the main clinical features of this infrequent, but severe, emerging complication. We also summarise experimental data and clinical observations that support the use of L-carnitine supplementation to reverse NRTI-induced mitochondrial impairment.
Claessens
Yann-Erick
YE
Service de Réanimation Polyvalente, Hôpital Cochin and Institut Cochin, Paris, France. yann-erick.claessens@cch.ap-hop-paris.fr
Chiche
Jean-Daniel
JD
Mira
Jean-Paul
JP
Cariou
Alain
A
D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D002331:Carnitine / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D008928:Mitochondria / Q000187:drug effects; D009705:Nucleosides / Q000009:adverse effects*; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*
D019380:Anti-HIV Agents; D009705:Nucleosides; D018894:Reverse Transcriptase Inhibitors; D019344:Lactic Acid; D002331:Carnitine