Lactic acidosis associated with stavudine administration: a report of five cases.

Abstract

Type "B" lactic acidosis has been described in patients receiving the nucleoside analogs zidovudine, didanosine, and fialuridine. Lactic acidosis has also been described in 4 patients receiving combination therapy with stavudine and lamivudine. We describe the development of chronic type "B" lactic acidosis in 3 patients receiving stavudine as a single agent and in 2 patients receiving combination therapy with stavudine and either lamivudine or delavirdine, a nonnucleoside analog. All patients presented with abdominal pain, vomiting, and hepatic steatosis. Other signs of mitochondrial toxicity included pancreatitis and myopathy (2 cases). The mean duration of stavudine therapy was 9.4 months, and the mean observed peak lactate level+/-SD was 10.3+/-5 mmol/L. After discontinuation of stavudine treatment, lactic acidosis improved in 4 patients after 4-60 weeks, and 1 patient died. Evaluations for other causes of lactic acidosis, including hypoxemia, malignancy, sepsis, and cardiogenic shock, were negative.

• Authors: M H Mokrzycki, C Harris, H May, J Laut, J Palmisano
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 30 Issue 1 Pg. 198-200 (Jan 2000) ISSN: 1058-4838 [Print] United States
• PMID: 10619755 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-HIV Agents
• Reverse Transcriptase Inhibitors
• Stavudine

Topics

• Acidosis, Lactic (chemically induced)
• Adult
• Anti-HIV Agents (adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• HIV Infections (drug therapy)
• Humans
• Male
• Middle Aged
• Reverse Transcriptase Inhibitors (adverse effects)
• Stavudine (adverse effects)