Severe lactic acidosis associated with antiretroviral therapy

• Autor(a) principal: Gomes, Ana
• Data de Publicação: 2006
• Outros Autores: Nunes, Lúcia, Albuquerque, Ana, Marques, António, Arede, Maria José, Barros, Inês, Viana, Paula, Pimentel, António
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1633
• topic: acidose láctica; infecção VIH; terapêutica antirretroviral; lactic acidosis; antiretroviral therapy; HIV infection

Lactic acidosis is a rare but potentially fatal complication of antiretroviral therapy with nucleoside analogue reverse transcriptase inhibitors. The authors present the case of a 30-year old HIV positive woman, treated with didanosine, stavudine and efavirenz for six months, who was admitted to our Intensive Care Unit for severe lactic acidosis. On admission she was confused, with abdominal pain and her respiratory rate was increased. The blood pH was 6.68 and she had a serum lactate of 25 mmol/L which rose up to 28 mmol/L. Besides respiratory support and fl uids with bicarbonates, she was treated with tiamin, riboflavin and l-carnitine. She had several complications namely circulatory shock, steatohepatitis, pancreatitis, renal insufficiency and ventilator associated pneumonia. She was discharged after 31 days with marked clinical improvement.The authors discuss the pathophysiologic mechanisms, risk factors, clinical aspects, therapeutics, and prevention strategies for lactic acidosis.