Fatal portal hypertension, liver failure, and mitochondrial dysfunction after HIV-1 nucleoside analogue-induced hepatitis and lactic acidaemia

Lancet. 2001 May 5;357(9266):1412-4. doi: 10.1016/S0140-6736(00)04579-7.

Abstract

Acute hepatitis with lactic acidosis is a life-threatening but reversible toxic effect on mitochondria of HIV-1 nucleoside-analogue treatment. We report fatal portal hypertension, liver failure, and persistent mitochondrial dysfunction in a man aged 65 years with HIV-1 infection who had recovered from nucleoside-analogue-induced acute hepatitis and lactic acidaemia more than 18 months previously. We believe that symptom free patients who receive nucleoside-analogue therapy should have hepatic function constantly monitored, especially those with past or present lactic acidaemia.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / complications
  • Chemical and Drug Induced Liver Injury / pathology*
  • Didanosine / adverse effects
  • Didanosine / therapeutic use
  • Fatal Outcome
  • Fatty Liver / pathology
  • HIV Infections / drug therapy*
  • HIV-1*
  • Humans
  • Hypertension, Portal / chemically induced*
  • Hypertension, Portal / complications
  • Male
  • Mitochondria, Liver / drug effects*
  • Stavudine / adverse effects
  • Stavudine / therapeutic use
  • Zidovudine / adverse effects
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Zidovudine
  • Stavudine
  • Didanosine