Marra A, Lewi D, Lanzoni V, Wey S B, Odashiro L N, Gomes P S, Silva E
Medical School of S'o Paulo, Federal University of São Paulo, SP, Brazil.
Braz J Infect Dis. 2000 Jun;4(3):151-5.
Antiretrovirals, particularly nucleoside analogue reverse transcriptase inhibitors (RTIs) - DDI, 3TC and D4T, are widely used to effectively control human immunodeficiency virus (HIV) infection. These drugs have several adverse effects including anemia, peripheral neuropathy, pancreatitis and, on rare occasions, lactic acidosis. We describe the case of a 39 year old patient who had severe lactic acidosis after receiving stavudine (D4T) and didanosine (DDI) for an 8 month period. She had never manifested an opportunistic infection and presented a CD4 count of 378 cells/mm3 and an undetectable viral load (< 400 copies/ml). The purpose of the following report is to alert clinicians and infectious diseases specialists to the occurrence of lactic acidosis in asymptomatic HIV patients receiving antiretrovirals for long periods of time.
抗逆转录病毒药物，特别是核苷类逆转录酶抑制剂（RTIs）——去羟肌苷（DDI）、拉米夫定（3TC）和司他夫定（D4T），被广泛用于有效控制人类免疫缺陷病毒（HIV）感染。这些药物有多种不良反应，包括贫血、周围神经病变、胰腺炎，以及罕见的乳酸性酸中毒。我们描述了一名39岁患者的病例，该患者在接受司他夫定（D4T）和去羟肌苷（DDI）治疗8个月后出现了严重的乳酸性酸中毒。她从未发生过机会性感染，CD4细胞计数为378个/立方毫米，病毒载量检测不到（<400拷贝/毫升）。以下报告的目的是提醒临床医生和传染病专家，在长期接受抗逆转录病毒治疗的无症状HIV患者中会发生乳酸性酸中毒。
