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7th Annual Conference Of The British HIV Association [BHIVA]27 – 29 April 2001, The Hove Centre, Brighton |
[AUTHOR(S):] L Sarner, A Fakoya
The Greenway Centre, Newham General Hospital, London, UK
BHIVA Conf 2001 Apr 27-29;7:O23
INTRODUCTION: Mitochondrial toxicity is now well recognised as a result of nucleoside analogue therapy. We present two cases of acute lactic acidosis in the third trimester of pregnancy.
CASE 1: A 30-year-old woman (CD4 count 450 cells/µl, viral load <50 HIV-1 RNA copies/ml) taking didanosine, stavudine and nevirapine for 3 years, presented in the 37th week of pregnancy with an acute onset of severe lactic acidosis (lactate 22.5 mmol/l), resulting in maternal and foetal death.
CASE 2: A 31-year-old woman (CD4 count 650 cells/µl, viral load <50 HIV-1 RNA copies/ml) taking didanosine, stavudine and nevirapine for 2 years presented in the 33rd week of pregnancy with acute-onset lactic acidosis (lactate 6.8 mmol/l) and pancreatitis (amylase 1990 IU/l).
TREATMENT: Both cases were managed supportively and given riboflavin, resulting in a full recovery and delivery of a live infant in the second case.
DISCUSSION: Studies show that late pregnancy may be associated with low riboflavin levels. This, in combination with mitochondrial toxicity, may precipitate sudden-onset severe lactic acidosis. Heightened awareness and further evaluation of risk factors and screening tools is required.
PRESENTING AUTHOR: L Sarner
010427
O23
Copyright © 2001 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD