Is it safe to switch from stavudine to zidovudine after developing symptomatic hyperlactatemia?

A high incidence of lactic acidosis and symptomatic hyperlactatemia in women receiving highly active antiretroviral therapy in Soweto, South Africa.

BACKGROUND Lactic acidosis and symptomatic hyperlactatemia may complicate nucleoside reverse-transcriptase inhibitor use. Females may be at increased risk for such complications. Our study evaluated the incidence of lactic acidosis and symptomatic hyperlactatemia by sex, analyzed clinical features, and described the safety of reintroducing highly active antiretroviral therapy (HAART) with zidov...

A Risk-Factor Guided Approach to Reducing Lactic Acidosis and Hyperlactatemia in Patients on Antiretroviral Therapy

BACKGROUND Stavudine continues to be used in antiretroviral treatment (ART) regimens in many resource-limited settings. The use of zidovudine instead of stavudine in higher-risk patients to reduce the likelihood of lactic acidosis and hyperlactatemia (LAHL) has not been examined. METHODS Antiretroviral-naïve, HIV-infected adults initiating ART between 2004 and 2007 were divided into cohorts o...

Renal safety of tenofovir in HIV-infected patients who switch from stavudine or zidovudine to tenofovir

HIV-associated neuromuscular weakness syndrome in Brazil: report of the two first cases.

We describe two Brazilian patients with HIV-associated neuromuscular weakness syndrome (HANWS), a unique clinical toxic syndrome that was recently reported in developed countries. Both patients were women, used stavudine and had hyperlactatemia, one of them with lactic acidosis. Electrophysiological studies were consistent with axonal neuropathy. After discontinuation of antiretroviral therapy ...

Symptomatic hyperlactatemia associated with nucleoside analogue reverse-transcriptase inhibitor use in HIV-infected patients: a report of 24 cases in a resource-limited setting (Uganda).

We describe 24 Ugandan patients with human immunodeficiency virus infection who developed symptomatic hyperlactatemia associated with the use of nucleoside analogues. All patients were receiving combination therapy that contained stavudine. The median serum lactate level was 6.6 mmol/L. All patients had their antiretroviral treatment regimen discontinued. Hospital admission was required for 5 p...