| Hyperlactatemia syndromes in people with HIV infection. | |
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MedLine Citation:
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PMID: 11964902 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hyperlactatemia associated with use of nucleoside analogue reverse transcriptase inhibitors (NRTIs) is not a single entity but a spectrum of abnormalities. The spectrum reflects varying degrees of derangement in systemic homeostasis in the face of primary drug effects on lactate load. Lactic acidosis, characterized by metabolic acidosis, blood lactate above 5 mmol/l, hepatic steatosis and high mortality, represents the extreme end of this spectrum where there is complete decompensation. Partially compensated states of lactate excess have now been described, ranging from less fulminant symptomatic hyperlactatemia with hepatic steatosis to chronic or intermittent low-grade hyperlactatemia without acidosis, steatosis or any symptoms. At a population level, average venous lactate concentrations do rise following treatment with NRTIs but stabilize long term in the majority of cases. The average increase in systemic lactate turnover that is required to maintain such compensated blood levels is not known and research into this may provide insights into the extent of incipient mitochondrial toxicity associated with chronic NRTI use. At a tissue-specific level, it is not known which tissues or organs (liver, fat, other) are the predominant contributors to an increase in systemic lactate load, nor whether the primary defect is one of increased production, decreased elimination or both. |
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Authors:
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Mina John; Simon Mallal |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Current opinion in infectious diseases Volume: 15 ISSN: 0951-7375 ISO Abbreviation: Curr. Opin. Infect. Dis. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-04-19 Completed Date: 2002-05-20 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8809878 Medline TA: Curr Opin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 23-9 Citation Subset: IM |
Affiliation:
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Centre for Clinical Immunology, North Block Level 2, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Mina.John@health.wa.gov.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acidosis, Lactic
/
chemically induced,
complications,
metabolism Anti-HIV Agents / adverse effects, therapeutic use Drug-Induced Liver Injury HIV Infections / complications*, drug therapy, metabolism* Homeostasis Humans Lactic Acid / metabolism* Liver Diseases / complications, metabolism Metabolic Diseases / chemically induced, complications*, metabolism* Nucleosides / adverse effects, therapeutic use Syndrome |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents; 0/Nucleosides; 50-21-5/Lactic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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