Severe lactic acidosis associated with antiretroviral therapy

Authors

  • Ana Gomes Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • Lúcia Nunes Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • Ana Albuquerque Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • António Marques Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • Maria José Arede Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • Inês Barros Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • Paula Viana Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu
  • António Pimentel Unidade de Cuidados Intensivos Polivalente do Hospital de S. Teotónio, Viseu

Keywords:

lactic acidosis, antiretroviral therapy, HIV infection

Abstract

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.

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References

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Additional Files

Published

2006-06-30

How to Cite

1.
Gomes A, Nunes L, Albuquerque A, Marques A, Arede MJ, Barros I, Viana P, Pimentel A. Severe lactic acidosis associated with antiretroviral therapy. RPMI [Internet]. 2006 Jun. 30 [cited 2024 Dec. 18];13(2):103-8. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/1633

Issue

Vol. 13 No. 2 (2006): Abril/ Junho

Section

Case Reports

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