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Lactic Acidosis
May 7, 2001

What is Lactic Acidosis? How is it monitored? What causes it? Is it something I should ask my doctor to test for? Or is it measured in routine blood tests, like a CBC panel? My doc has never mentioned it. I am on a STI going on eight months because the side effects were getting worse. Extreme fatigue and GI problems were so bad that I had to take a break from the drugs. All my test results have been stable until now. My doctor is putting me back on meds soon. I want to be able to talk to him about this condition. I discovered my POZ status in 1987. I have been on many different HAART regimens since 1990. I have been treated for NHL and have been in remission for three years. The NHL came as a surprise. I dont want any more surprises. Thanks for you time.

Response from Dr. Young

Lactic acidosis is the disease caused by a abnormally high lactic acid level in the blood. It is important to distinguish between small elevations in lactic acid levels (called hyperlactatemia; may be caused by HIV itself, and probably not dangerous) and dangerous elevations. Individuals who have lactic acidosis usually feel ill, with malaise, body or muscle aches. Abdominal pain is frequent.

The causes of lactic acidosis are many, but most commonly associated with a rare complication of the use of nucleoside RT inhibitors (all have been implicated, but most commonly with ddI and d4T). Serious elevations in lactic acid levels are often associated with liver and/or pancreatic injury (whether associated with NRTIs or not); these conditions are often very serious or life threatening and may require hospitalization.

Lactic acidosis is detected by special blood testing; this test needs to be done carefully, incorrectly performed tests may give the false impression of abnormalities. Lactic acidosis is not ususally detected with the typical panel of blood tests.

Treatment for lactic acidosis involves stopping the offending agents and supportive hospital care, when necessary.

I hope this helps, BY



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