HIV/AIDS病人HAART相关的高乳酸血症/乳酸酸中毒研究进展

The research progress in HAART-related hyperlactacidemia/lactic acidosis in HIV/AIDS patients

在发展中国家,由于高效抗反转录病毒治疗(HAART)的引进和广泛地应用,使得艾滋病(HIV/AIDS)病人的患病率和病死率大大下降。中国自从2003年开始,在政府的倡导下,广泛开展艾滋病的免费抗病毒治疗,其主要的方案是以核苷类药物(NRTIs)司他夫定(d4T)、齐多夫定(AZT)或去羟肌苷(DDI)为骨干的,而核苷类药物的主要不良反应是线粒体毒性。在线粒体毒性中最严重的甚至是威胁生命的高乳酸血症和乳酸酸中毒。文章就高乳酸血症的发生率、发生机制、临床表现、诊断、治疗和预后进行综述。

Since HAART are taken in AIDS patients in developing countries,the morbidity and mortality of opportunistic infections have been significantly reduced.Since 2003,free HAART treatment have been carried out with support of the Chinese government,in which nucleoside analogs such as stavudine,zidovudine or didanosine are treated as backbone.The main side effect of nucleoside analogs is mitochondrial toxicity,resulting in hyperlactacidemia/lactic acidosis.In this review,we have summarized the incidence,mechanisms,clinical manifestations,diagnosis,treatment and prognosis of hyperlactacidemia/lactic acidosis in HIV/AIDS patients.