Lactic acidosis in HIV-exposed infants with perinatal exposure to antiretroviral therapy

Annals of Tropical Paediatrics
Ira Shah

Abstract

Prolonged exposure to nucleoside reverse transcriptase inhibitors (NRTI) is known to be associated with lactic acidosis (LA) and hepatosteatosis. However, perinatal exposure to antiretroviral therapy (ART) and the subsequent development of symptomatic LA in infants, although recognised, is rarely reported in developing countries. Three infants born to HIV-infected mothers and who developed symptomatic lactic acidaemia associated with perinatal exposure to ZVD are reported. The first infant was HIV-infected and developed liver dysfunction and mental retardation at 5 months of age after exposure to 24 weeks of ZVD antenatally and 6 weeks of ZVD plus 4 weeks of ART triple-drug ART postnatally. The second and third infants were HIV-uninfected. The second infant had been exposed to ZVD for 14 weeks antenatally and for 6 weeks postnatally and presented with LA at 6 weeks of age. The third infant was exposed to ZVD, lamivudine and nevirapine for 9 weeks antenatally and 6 weeks of ZVD postnatally, and presented with life-threatening metabolic acidosis at 10 weeks. In HIV-exposed infants, perinatal NRTI may lead to symptomatic LA and monitoring for symptoms is therefore essential.

References

Sep 25, 2003·The Pediatric Infectious Disease Journal·Antoni NogueraRafael Jiménez
Sep 25, 2003·The Pediatric Infectious Disease Journal·Ariane AlimentiJohn C Forbes
Apr 13, 2004·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Gabriella VerucchiFrancesco Chiodo
Jun 21, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M G Bolhaar, A S Karstaedt

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Citations

May 24, 2011·Gastroenterology Clinics of North America·Silvia Degli Esposti, Dhvani Shah
Jan 1, 2014·The Pediatric Infectious Disease Journal·Jennifer Jao, Elaine J Abrams

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