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Lactic acidosis and abnormal liver function in advanced HIV disease
M Shahmanesh1, J Cartledge, R Miller
1Department of Genito-Urinary Medicine, Mortimer Market Centre, Camden and Islington Community Health Services NHS Trust, London, UK.
Sexually Transmitted Infections
|June 26, 2002
Summary
Highly Active Antiretroviral Therapy (HAART) may cause liver failure in advanced HIV disease. A patient developed non-cirrhotic cholestasis and progressive liver failure, leading to ICU admission.
Area of Science:
- Hepatology
- Infectious Diseases
- Pharmacology
Background:
- Highly Active Antiretroviral Therapy (HAART) is crucial for managing advanced Human Immunodeficiency Virus (HIV) disease.
- While effective, HAART regimens can have complex side effect profiles, including potential hepatotoxicity.
Observation:
- A 48-year-old male with late-stage HIV disease on HAART presented with ascites and lactic acidosis.
- Initial liver biopsy was unsuccessful; subsequent ICU admission was required due to worsening acidosis and progressive liver failure.
Findings:
- Endoscopic examination revealed esophageal varices.
- A transjugular liver biopsy demonstrated non-cirrhotic cholestasis, a finding attributed to HAART treatment.
Implications:
- This case highlights a potential, albeit rare, adverse effect of HAART, specifically non-cirrhotic cholestasis leading to liver failure.
- Clinicians should consider HAART-induced liver injury in patients with advanced HIV presenting with unexplained cholestatic liver disease.
- Further research into the specific mechanisms and prevalence of HAART-associated cholestasis is warranted.