Background: An association between use of zidovudine and didanosine and a rare but life-threatening syndrome of hepatic steatosis, lactic acidosis, and myopathy has been reported. Objective: To describe the syndrome of hepatic steatosis, lactic acidosis, and myopathy in four patients taking stavudine. Design: Case series. Setting: A community hospital in Washington, D.C., and National institutes of Health Clinical Center, Bethesda, Maryland. Patients: Two men and two women with HIV-1 infection who were taking stavudine presented with lactic acidosis and elevated levels of aminotransferases. All patients required intensive care. Measurements: Levels of lactic acid, alanine aminotransferase, aspartate aminotransferase, amylase, and lipase; computed tomography of the abdomen; liver biopsy (two patients); and muscle biopsy (two patients). Results: Histologic findings consistent with mitochondrial injury confirmed the diagnosis of hepatic or muscle abnormality. Conclusion: Because hepatic steatosis may be life-threatening, physicians should consider it as a possible cause of elevated hepatic aminotransferase levels among patients taking stavudine.
CITATION STYLE
Miller, K. D., Cameron, M., Wood, L. V., Dalakas, M. C., & Kovacs, J. A. (2000). Lactic acidosis and hepatic steatosis associated with use of stavudine: Report of four cases. Annals of Internal Medicine, 133(3), 192–196. https://doi.org/10.7326/0003-4819-133-3-200008010-00010
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