Severe Lactic Acidosis Induced by Nucleoside Analogues in an HIV-Infected Man

Nucleoside analogues can induce myopathy or hepatitis by means of mitochondrial dysfunction. We report the case of a 31-year-old man infected with HIV who had a severe lactic acidosis without muscle or liver symptoms. He improved after hemodialysis and withdrawal of antiviral drugs. Muscle and liver evaluation allowed us to ascribe lactic acidosis to a mitochondriopathy induced by zidovudine and didanosine. [Roy P-M, Gouello J-P, Pennison-Besnier I, Chennebault J-M: Severe lactic acidosis induced by nucleoside analogues in an HIV-infected man. Ann Emerg Med August 1999;34:282-284.]