Important note: Information in this article was accurate in December 2000. The state of the art may have changed since the publication date. 
Drugs such as AZT, d4T and ddI, commonly called nukes, may be associated with a number of side effects including the following:
Some researchers think that these problems occur because nukes damage the energy-producing parts of cells called mitochondria (Mt). Large number of damaged or malfunctioning Mt produce lactic acid (lactate). When high levels of lactic acid in the blood occur, this is known as lactic acidosis. Generally, this condition is uncommon in PHAs. Indeed, a recent French study suggests that over a period of two years, only about 1% of PHAs taking anti-HIV therapy develop this complication. People with hepatitis B or C are at increased risk for developing lactic acidosis. Symptoms of lactic acidosis include the following:
The following blood tests help identify PHAs with lactic acidosis:
A team of Dutch doctors have developed a protocol for rescuing their patients with lactic acidosis and we present their results.
The PHAs receive saline solution infused into a vein. As well, nurses give these PHAs the following nutrients, infused into a vein, twice daily:
The doctors continue to prescribe these nutrients until lactate levels "fall below 3 mmol/L". When this happens they consider switching from intravenous to oral administration of nutrients.
With this regimen some PHAs recover from lactic acidosis in as few as four days, others have taken as long as three weeks. According to the team, an average of 50% of people with lactic acidosis die. When given intravenous nutrients, however, the Dutch doctors have managed to save six out of six PHAs. Heartened with this success, the doctors plan to continue their approach.
1. AIDS 2000;14(17):2801-2803.
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Copyright © 2000 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca
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