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Báo cáo y học: "Bench-to-bedside review: Severe lactic acidosis in HIV patients treated with nucleoside analogue reverse transcriptase inhibitors"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Bench-to-bedside review: Severe lactic acidosis in HIV patients treated with nucleoside analogue reverse transcriptase inhibitors. | Critical Care June 2003 Vol 7 No 3 Claessens et al. Review Bench-to-bedside review Severe lactic acidosis in HIV patients treated with nucleoside analogue reverse transcriptase inhibitors Yann-Erick Claessens1 Jean-Daniel Chiche1 Jean-Paul Mira1 and Alain Cariou2 11ntensivist and Scientist Service de Réanimation Polyvalente Hôpital Cochin and Institut Cochin Paris France 2Intensivist Service de Réanimation Polyvalente Hôpital Cochin Paris France Correspondence Yann-Erick Claessens yann-erick.claessens@cch.ap-hop-paris.fr Published online 28 February 2003 Critical Care 2003 7 226-232 DOI 10.1186 cc2162 This article is online at http ccforum.com content 7 3 226 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Nucleoside reverse transcriptase inhibitors NRTIs are effective antiretroviral therapy for the treatment of HIV-infected patients. NRTIs can induce mitochondrial impairment that leads to a number of adverse events including symptomatic lactic acidosis. In the present review we describe the underlying mechanism of NRTI-induced toxicity and the main clinical features of this infrequent but severe emerging complication. We also summarise experimental data and clinical observations that support the use of L-carnitine supplementation to reverse NRTI-induced mitochondrial impairment. Keywords antiretroviral drug critically ill patients HIV lactic acidosis mitochondria Nucleoside analogue reverse transcriptase inhibitors NRTIs are effective antiretroviral therapies for the treatment of HIV-infected patients. Treatment with NRTIs has been associated with mitochondrial toxicity 1 responsible for adverse events including hepatic steatosis 2 myopathy 3 neuropathy 4 myelotoxicity 5 and overproduction of lactate 1 . Symptomatic lactic acidosis following the use of NRTIs was first described by Jolliet and Widmann 6 and by Chatta and colleagues 7 in HIV-infected patients treated with azidothymidine. Several reports since then have established that .