title: Lactic Acidosis Complicating Metformin and Non-Nucleoside Reverse Transcriptase Inhibitor Combination Therapy: A Smoldering Threat in the Post-HAART Era.
abstract: Dear Editor, The prevalence of type 2 diabetes (DM-2) in HIV-infected patients and the concomitant use of metformin (MTF) and non-nucleoside reverse transcriptase inhibitors (NRTI) is rising. Through inhibition of NADH dehydrogenase and DNA pol-γ, both drugs hinder oxidative phosphorylation that may lead to lactic acidosis (LA). Among NRTIs, abacavir and tenofovir have the lowest mitochondrial toxicity, with only a few LA cases reported2-4. We describe here a case of MTF-associated LA (MALA) secondary to the interaction with NRTI.
authors.affiliation: Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México.
authors.forename: Edgar
authors.initials: E
authors.lastname: Ortiz-Brizuela
authors.affiliation: Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México.
authors.forename: Santiago
authors.initials: S
authors.lastname: Pérez-Patrigeon
authors.affiliation: Department of Ophthalmology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México.
authors.forename: Claudia
authors.initials: C
authors.lastname: Recillas-Gispert
authors.affiliation: Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Gómez-Pérez
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004347:Drug Interactions; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D007004:Hypoglycemic Agents; D018894:Reverse Transcriptase Inhibitors; D008687:Metformin