[Toxicity of antiretroviral drugs]

METABOLIC DISORDERS: Lactic acidosis is one of the metabolic disorders provoked by antiretorviral drugs. Incidence, particularly cases of mild acidosis, appears to be rising. Symptoms are generally nonspecific. Early detection is based on history taking, physical examination, assay of arterial blood lactates. Discontinuing treatment prevents fatal outcome. LIPODYSTROPHY: Changes in fat distribution or lipodystrophy can be cause by antiretorviral drugs other than proteases (stavudine, nucleoside inhibitor combinations). The lipodystrophy results from many drug-related and host-related factors. Treatment is based on diet with or without lipid lowering drugs (fibrates). Prudence is required when attempting a substitution of the antiretroviral drugs because of the possible loss of control of viral charge.