Lactic acidosis in an HIV-infected patient receiving highly active antiretroviral therapy.

摘要: Background A 51-year-old man with HIV infection on highly active antiretroviral therapy presented abdominal pain and exertional dyspnea. Physical examination revealed increased respiration cachexia. Laboratory tests showed a lactic acid concentration elevated to 6.4 mM. Investigation examination, blood chemistry, arterial gas, urine analysis, chest X-ray, ultrasound of liver. Diagnosis Nucleoside reverse transcriptase inhibitor (NRTI)-induced acidosis, hepatitis chemical pancreatitis. Proximal renal tubular acidosis Fanconi's syndrome, secondary treatment tenofovir. Management The patient was supported intravenous oral bicarbonate, riboflavin phosphorus supplementation. Highly discontinued. patient's lactate level decreased about 2 weeks after discharge.