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CMAJ • January 21, 2003; 168 (2)
© 2003 Canadian Medical Association or its licensors

PRACTICE

Symptomatic hyperlactatemia in an HIV-positive patient: a case report and discussion

Tony Antoniou, Thea Weisdorf and Kevin Gough

Mr. Antoniou is an HIV primary care pharmacist at St. Michael's Hospital, Toronto, Ont. Dr. Weisdorf is a family physician at St. Michael's Hospital and Assistant Professor in the Department of Family and Community Medicine, University of Toronto. Dr. Gough is an infectious diseases consultant and Medical Director of the HIV Service and Positive Care Clinic, St. Michael's Hospital.

Correspondence to: Mr. Tony Antoniou, Health Centre at 410, 410 Sherbourne St., Toronto ON M4X 1K2; fax 416 867-3726; tantoniou{at}smh.toronto.on.ca

Abstract

PROLONGED EXPOSURE TO HIGHLY ACTIVE antiretroviral therapy may be associated with adverse effects related to mitochondrial toxicity, such as hyperlactatemia. We describe a case of symptomatic hyperlactatemia in an HIV-positive patient to illustrate the subtle clinical symptoms and abnormal laboratory test results associated with this condition. We also review the pathophysiology, prevalence, spectrum and management of disturbances in lactate homeostasis induced by nucleoside reverse transcriptase inhibitors.




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