TENOFOVIR INDUCED SEVERE LACTIC ACIDOSIS AND HEPATITIS

Tenofovir induced hepatitis and severe lactic acidosis is rare. We report a rare case of tenofovir causing hepatitis in severe lactic acidosis in a seropositive patient with none of the identifiable risk factor. A 50 years old seropositive male on ZLN (Zidovudine, Lamivudine, Nevirapine) regimen sin...

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Bibliographic Details
Published in:National journal of medical research 2016-09, Vol.6 (3)
Main Authors: Chirag M Chhatwani, Jinesh B Purohit, Ankit P Vakil, Sanjay L Khunt
Format: Article
Language:English
Subjects:
Anti retroviral therapy
Hepatitis
HIV
Severe Lactic Acidosis
Tenofovir
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Summary:Tenofovir induced hepatitis and severe lactic acidosis is rare. We report a rare case of tenofovir causing hepatitis in severe lactic acidosis in a seropositive patient with none of the identifiable risk factor. A 50 years old seropositive male on ZLN (Zidovudine, Lamivudine, Nevirapine) regimen since 3 years admitted under medicine care with complaints of weakness, fatigability and giddiness since 1 month. All investigations were normal apart from hemoglobin which was 4.5 gm/dL. ART regimen was changed to TLE (Tenofovir, Lamivudine, Efavirenz). After 3 days, patient had nausea, vomiting, upper abdominal pain and breathlessness. Investigations showed aspartate transaminase was 2400 IU/L, alanine transaminase 2706 IU/L, serum bilirubin 0.6 mg/dL, alkaline phosphatase 108 IU/L, PT 14 sec, INR 1.4, serum urea 16 mg/dL and serum creatinine 0.8 mg/dL. Arterial blood gas evaluation showed pH 6.96, PaO 2 116, PaCO2 12, HCO3 1.6. Serum lactate levels were 42 mg/dl. Viral markers were negative. Diagnosis of tenofovir induced hepatitis and lactic acidosis was made. Patient improved after stopping Tenofovir.
ISSN:2249-4995
2277-8810