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Lactic acidosis in HIV-exposed infants with perinatal exposure to antiretroviral therapy

Ira Shah1

  • 1HIV Clinic, Department of Pediatrics, B. J. Wadia Hospital for Children, Mumbai, India. irashah@pediatriconcall.com

Annals of Tropical Paediatrics
|November 28, 2009
PubMed

Insights

Perinatal exposure to nucleoside reverse transcriptase inhibitors (NRTI) in infants can lead to symptomatic lactic acidosis (LA). Monitoring for LA symptoms in HIV-exposed infants receiving NRTI is crucial.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Toxicology

Background:

  • Nucleoside reverse transcriptase inhibitors (NRTI) are associated with lactic acidosis (LA) and hepatosteatosis with prolonged use.
  • Symptomatic LA in infants due to perinatal antiretroviral therapy (ART) exposure is rarely reported in developing nations.

Observation:

  • Three cases of infants developing symptomatic lactic acidaemia following perinatal exposure to zidovudine (ZVD) are presented.
  • One HIV-infected infant exposed antenatally and postnatally to ZVD developed liver dysfunction and mental retardation.
  • Two HIV-uninfected infants exposed to ZVD, with or without other ART drugs, presented with LA and metabolic acidosis.

Findings:

  • Perinatal NRTI exposure, including ZVD, can cause symptomatic LA in HIV-exposed infants.
  • The severity of LA varied, with one case presenting as life-threatening metabolic acidosis.

Implications:

  • Healthcare providers should monitor HIV-exposed infants for symptoms of LA, especially those with perinatal NRTI exposure.
  • Early detection and intervention are essential for managing NRTI-induced LA in infants.
  • This highlights a potential risk of ART in developing countries where reporting is scarce.
Abstract

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