Symptomatic elevations of lactic acid and their response to treatment manipulation in human immunodeficiency virus-infected persons: a case series.

Symptomatic lactic acidemia was seen in 5 human immunodeficiency virus-positive patients receiving combination therapy that included stavudine and > or =1 other nucleoside. Peak venous lactic acid levels of 3.1-7.4 mmol/L (normal range, 0.5-2.1 mmol/L) were associated with fatigue and rapid weight loss, whereas withdrawal of antiretrovirals led to normalization of venous lactic acid levels, symptomatic improvement, and weight gain. Resumption of an altered therapeutic regimen, which did not include stavudine but did include other nucleosides in 4 of 5 cases, did not result in recurrence of the syndrome after up to 126 days.

[1]  B. Mégarbane,et al.  [Lactic acidosis and multi-organ failure secondary to anti-retroviral therapy in HIV-infected patients]. , 1999, Presse medicale.

[2]  C. Schramm,et al.  Thiamine for the treatment of nucleoside analogue-induced severe lactic acidosis. , 1999, European journal of anaesthesiology.

[3]  P. Roy,et al.  Severe lactic acidosis induced by nucleoside analogues in an HIV-infected man. , 1999, Annals of emergency medicine.

[4]  E. Grimsley,et al.  Zidovudine-associated type B lactic acidosis and hepatic steatosis in an HIV-infected patient. , 1999, Southern medical journal.

[5]  E. Zafrani,et al.  Zidovudine-induced mitochondrial disorder with massive liver steatosis, myopathy, lactic acidosis, and mitochondrial DNA depletion. , 1999, Journal of hepatology.

[6]  J. Smeitink,et al.  Adverse effects of reverse transcriptase inhibitors: mitochondrial toxicity as common pathway , 1998, AIDS.

[7]  Lenzo Np,et al.  Hepatic steatosis and lactic acidosis associated with stavudine treatment in an HIV patient: a case report. , 1997 .

[8]  J. Shapiro,et al.  Zidovudine-induced fatal lactic acidosis and hepatic failure in patients with acquired immunodeficiency syndrome: report of two patients and review of the literature. , 1997, Critical care medicine.

[9]  N. Lenzo,et al.  Hepatic steatosis and lactic acidosis associated with stavudine treatment in an HIV patient: a case report. , 1997, AIDS.

[10]  J. Olano,et al.  Massive hepatic steatosis and lactic acidosis in a patient with AIDS who was receiving zidovudine. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  J. L. Martin,et al.  Effects of antiviral nucleoside analogs on human DNA polymerases and mitochondrial DNA synthesis , 1994, Antimicrobial Agents and Chemotherapy.

[12]  C. Tsai,et al.  Comparison of mitochondrial morphology, mitochondrial DNA content, and cell viability in cultured cells treated with three anti-human immunodeficiency virus dideoxynucleosides , 1994, Antimicrobial Agents and Chemotherapy.

[13]  R. Gherardi,et al.  Optimal handling of blood samples for routine measurement of lactate and pyruvate. , 1994, Archives of pathology & laboratory medicine.

[14]  M. Chevallier,et al.  Fulminant hepatitis with severe lactate acidosis in HIV‐infected patients on didanosine therapy , 1994, Journal of internal medicine.

[15]  K. K. Lai,et al.  Fulminant hepatic failure associated with 2',3'-dideoxyinosine (ddI). , 1991, Annals of internal medicine.

[16]  J H Wilmore,et al.  Anaerobic threshold and maximal aerobic power for three modes of exercise. , 1976, Journal of applied physiology.