A rare case of fatal lactic acidoisis and hepatitis with tenofovir and lamivudine

Nucleotide analogues have the potential to cause mitochondrial (mt) toxicity which may lead to the development of lactic acidosis (LA). Tenofovir, a nucleotide analogue-induced LA is extremely rare because of its low affinity for mt DNA polymerase. We report a rare case of tenofovir and lamivudine causing severe hepatitis and lactic acidosis, resulting in death in a seropositive patient with an identifiable risk factor of very low CD4 count.