Lactic Fetus

Two HIV-1-positive women, both of whom had taken regimens containing stavudine and didanosine for at least 2 years, presented in the third trimester of pregnancy, one with acute lactic acidosis and one with acute pancreatitis and lactic acidosis (32). In the first case both mother and baby died. It is not known whether pregnancy is a risk factor for NRTI-induced lactic acidosis, perhaps in combination with riboflavin deficiency or a metabolic defect in the fetus, or whether NRTIs independently cause lactic acidosis through mitochondrial toxicity. 

The fate of lactic dehydrogenase differs from that of the glycolytic enzymes. The activity of that enzyme is the same in fetus and adult, but lactic dehydrogenase activity increases immediately after birth. During the first five days after birth, the enzyme s activity is about 250 times that of the adult. The activity slowly drops to the adult value between the 5th and 21st day after birth. 

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