Khouri S, Cushing H
Department of Internal Medicine, Indiana University Medical Center, Indianapolis, USA.
AIDS Read. 2000 Oct;10(10):602-6.
A 53-year-old woman with newly diagnosed HIV infection was treated with the nucleoside analogue antiretroviral agents lamivudine and stavudine and the protease inhibitor indinavir. An illness characterized by severe lethargy, persistent nausea and vomiting, lactic acidosis, hyperglycemia, and microvesicular hepatic steatosis developed. Her symptoms improved gradually after withdrawal of the antiretroviral agents. The illness can be explained by mitochondrial dysfunction caused by inhibition of mitochondrial DNA (mtDNA) polymerase by the nucleoside analogues. The patient was successfully treated with nonnucleoside reverse transcriptase inhibitors, which lack affinity for mtDNA polymerase.
一名新诊断为HIV感染的53岁女性接受了核苷类似物抗逆转录病毒药物拉米夫定和司他夫定以及蛋白酶抑制剂茚地那韦治疗。随后出现了一种以严重嗜睡、持续性恶心和呕吐、乳酸性酸中毒、高血糖和微泡性肝脂肪变性为特征的疾病。停用抗逆转录病毒药物后，她的症状逐渐改善。这种疾病可以用核苷类似物抑制线粒体DNA（mtDNA）聚合酶导致的线粒体功能障碍来解释。该患者用对mtDNA聚合酶缺乏亲和力的非核苷类逆转录酶抑制剂成功治疗。
