Lactic acidosis associated with stavudine administration: A report of five cases

Michele H. Mokrzycki, Carol Harris, Helen May, Jeffrey Laut, Joseph Palmisano

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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.

Original languageEnglish (US)
Pages (from-to)198-200
Number of pages3
JournalClinical Infectious Diseases
Issue number1
Publication statusPublished - Feb 7 2000


ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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