• D Datta, G Moyle, S Mandalia, and B Gazzard.
• Kobler Clinic, Chelsea and Westminster Hospital, London, UK. dattauk@yahoo.co.uk
• HIV Med. 2003 Oct 1;4(4):311-4.

BackgroundLactic acidosis is a life-threatening event during antiretroviral therapy (ART). Hyperlactataemia may be a prelude to acidosis. Our database study suggested that female gender, intercurrent illness and didanosine (ddI)-based regimens may increase risk of lactic acidosis. The aim of this matched case-control study was to identify risk factors for hyperlactataemia requiring screening.MethodsCases were defined as patients with two consecutive lactate samples > or =3.5 mmol/L taken more than 1 week apart. Cases were matched to two controls on gender, use of ddI and total duration of therapy using a 6-month window on either side. Controls never had raised lactate >2.5 mmol/L. A conditional logistic regression analysis using the PHREG procedure in SAS (SAS Institute Inc, Cary, NC) was performed with a discreet logistic model stratified by matching variables.ResultsTwenty-one cases were matched to 42 controls. In the univariate model, current use of stavudine (d4T), total cholesterol >5.3 mmol/L and glucose levels > or =5.2 mmol/L gave increased likelihood of persistent hyperlactataemia. The multivariate model showed current use of d4T to be a significant independent predictor of persistent hyperlactataemia.ConclusionsThe results of this case-control study indicate that, when controlling for ddI use, d4T use is an additional risk factor for hyperlactataemia.

21 keywords...

hide…