Lactic acidosis in HIV infected children due to antiretroviral therapy.

INDIAN PEDIATRICS 1051 VOLUME 42OCTOBER 17, 2005 and hepatosplenomegaly. She was started on ART due to clinical deterioration and immunological suppression. Her serial CD4 and virological parameters with ART regimes are depicted in Table I. At 91⁄2 years of age, she had positive Mantoux test (20 × 15 mm) with weight loss and normal X-ray chest. She was started on antituberculous therapy (ATT) consisting of isoniazid and rifampicin for 6 months and ART regime was changed in view of clinical, immunological and virological deterioration (Table I). At 10 years of age, she presented with vomiting, hyperventilation, severe metabolic acidosis (pH = 7.09, HCO3 = 3.7 mmol/L), hyperbilirubinemia (5.1 mg/dL) and normal transaminases Serum lactate was 30 mg/dL. Ultrasound of abdomen revealed hepatomegaly.