What is a common side effect of nucleoside reverse transcriptase inhibitors (NRTIs)?

Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of antiretroviral drugs primarily used to manage HIV infection. One of the notable side effects associated with NRTIs is lactic acidosis. This condition occurs when there is an accumulation of lactic acid in the bloodstream, leading to a decrease in the blood's pH, which can be life-threatening if not addressed. The risk of lactic acidosis is particularly higher with specific NRTIs, such as zidovudine and stavudine, and can be attributed to the mitochondrial toxicity that some of these agents exhibit.

NRTIs can interfere with mitochondrial DNA replication, causing disruptions in cellular energy metabolism. This disruption can lead to excessive lactic acid production, particularly in cases where the body's ability to metabolize lactic acid diminishes.

Other potential side effects of NRTIs may include peripheral neuropathy, hypersensitivity reactions, and gastrointestinal issues, but lactic acidosis stands out as a severe and critical concern for patients taking these medications. It is crucial for healthcare providers to monitor patients for signs of this condition, especially in long-term treatment scenarios with NRTIs.