Severe nucleoside-associated lactic acidosis in human immunodeficiency virus-infected patients: Report of 12 cases and review of the literature

Vicente Falcó, Dolors Rodríguez, Esteban Ribera, Esteban Martínez, José Maria Miró, Pere Domingo, Ruth Diazaraque, José R. Arribas, Juan J. González-García, Francesc Montero, Lluis Sánchez, Albert Pahissa

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171 Citations (Scopus)

Abstract

Lactic acidosis is a rare but often fatal complication reported in some human immunodeficiency virus (HIV)-infected patients treated with nucleoside-analogue reverse-transcriptase inhibitors. We report a series of 12 patients with HIV infection treated with nucleoside analogues who developed unexplained metabolic acidosis. We have also reviewed 60 additional published cases. The aim of the present study is to describe the clinical picture, prognostic factors, and final outcome for nucleoside-associated lactic acidosis. The mortality rate is high: 33% for our patients, and 57% for the patients described in the literature. In the multivariate analysis, a lactate serum level of >10 mM (odds ratio [OR], 13.23; 95% confidence interval [CI], 2.96-59.25) was the only factor associated with higher mortality. The administration of specific therapy with cofactors against acidosis was associated with a lower mortality (OR, 0.17; 95% CI, 0.04-0.73). We conclude that specific therapy with cofactors may improve the outcome for patients with this syndrome.
Original languageEnglish
Pages (from-to)838-846
JournalClinical Infectious Diseases
Volume34
DOIs
Publication statusPublished - 1 Jan 2002

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