Lactic acidosis during telbivudine treatment for HBV: A case report and literature review

Table 1 Characteristics of patients with lactic acidosis treated with nucleoside analogues

Patient ID	Age (yr)	Liver condition	Underlying disease	Child-Pugh	MELD score	Drug	LA therapy	Peak lactate (mmol/L)	Nadir pH	BE (mmol/L)	Peak CPK (U/L)	Prognosis	Ref.
1	35	CHB	HOKPP	A	7	LDT	11 mo	> 12	7.2	-15.8	3683	Resolved	This paper
2	36	OLT, ITBL	-	C	38	ETV	9 mo	5.20	7.2	-18	Normal	Resolved	[7]
3	79	ALF	-	-	29	ETV	6 d	20.82	7.1	-17	Normal	Death	[7]
4	60	OLT, re-cirrhosis	-	C	28	ETV	1 mo	3.86	7.4	-5	Normal	Resolved	[7]
5	60	Cirrhosis HCC	-	B	25	ETV	10 d	6.77	7.3	-12	Normal	Resolved	[7]
6	61	Cirrhosis HCC	-	B	22	ETV	4 d	2.70	7.4	-6	Normal	Resolved	[7]
7	63	CHB, HCC	massive bilobar pneumonia	C	30	ETV	10 d	9.20	7.24	-	Normal	Resolved	[8]
8	54	CHB, cirrhosis	CML	C	24	ETV + ADV	10 d	9.50	6.95	-	Normal	Resolved	[9]
9	42	HIV	-	A	7	HARRT (stavudine + LAM)	9 mo	5.48	7.15	-	Normal	Resolved	[6]
10	51	HIV	DM	A	7	HARRT (tenofovir)	12 mo	6.40	7.21	-	Normal	Resolved	[7]

MELD: Model for end stage liver diseases; LA: Lactic acidosis; BE: Base excess; CPK: Creatine phosphokinase; CHB: Chronic hepatitis B; OLT: Orthotopic liver transplantation; ITBL: Ischemic-type biliary lesions; ALF: Acute liver failure; HCC: Hepatocellular carcinoma; HIV: Human immunodeficiency virus; HOKPP: Hypokalemia periodic paralysis; CML: Chronic myelogenous leukemia; DM: Diabetes mellitus; LAM: Lamivudine; ETV: Entecavir; ADV: Adefovir; LDT: Telbivudine; HARRT: Highly active antiretroviral treatment; Lactate mmol/L × 9.608 = mg/dL.