Lactic acidosis induced by tenofovir alafenamide
10.3760/cma.j.cn114015-20210322-00342
- VernacularTitle:丙酚替诺福韦致乳酸酸中毒
- Author:
Dongxue WANG
1
;
Feng XU
;
Jiqiu HOU
Author Information
1. 吉林大学第二医院药学部，长春 130041
- Publication Type:Journal Article
- Keywords:
Tenofovir;
Hepatitis B;
Antiviral agents;
Acidosis, lactic;
Blood lactic acid
- From:
Adverse Drug Reactions Journal
2022;24(1):46-48
- CountryChina
- Language:Chinese
-
Abstract:
A 32-year-old female patient received anti-virus treatment with tenofovir alafenamide one month after regular hemodialysis due to stage 5 chronic kidney disease complicated with chronic hepatitis B. At the same time, recombinant human erythropoietin injection and iron sucrose injection was periodically used to correct anemia. Her hemoglobin was about 96 g/L without clinical manifestations of anemia such as nausea and fatigue. Eight months after tenofovir alafenamide treatment, she developed dizziness, headache, nausea, fatigue, and lethargy. Laboratory tests showed hemoglobin 94 g/L and serum creatinine 856 μmol/L; blood gas analysis showed pH 7.05, lactate 3.3 mmol/L, arterial partial pressure of oxygen 80 mmHg, arterial partial pressure of carbon dioxide 23 mmHg, base excess -7.4 mmol/L, and bicarbonate 15.6 mmol/L. It was considered that the patient had lactic acidosis, which might be associated with tenofovir alafenamide. The drug was stopped and replaced by entecavir and symptomatic treatments such as fluid rehydration and liver protection were given. One day later, symptoms of dizziness and headache, etc. in the patient were improved and blood gas analysis showed pH 7.25, lactate 2.9 mmol/L, base excess -3.0 mmol/L; 5 days later, the above symptoms basically disappeared and blood gas analysis showed pH 7.45, lactate 1.5 mmol/L, base excess -2.0 mmol/L.
