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Prevalence, risk factors and outcome of hyperlactataemia in HIV-infected patients

L Hocqueloux1, C Alberti, J-P Feugeas

  • 1Clinique des Maladies Infectieuses, Département de Biostatistique et Informatique Médicale, Laboratoire de Biochimie B, Hôpital Saint-Louis, Paris, France.

HIV Medicine
|January 22, 2003
PubMed

Insights

Hyperlactataemia (HL) in HIV patients is linked to nucleoside reverse transcriptase inhibitors (NRTIs), particularly didanosine and stavudine. Discontinuing NRTIs can help resolve HL, which rarely leads to lactic acidosis or poorer outcomes.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Biochemistry

Background:

  • Hyperlactataemia (HL) is a potential complication in HIV-infected patients.
  • Understanding the prevalence, risk factors, and outcomes of HL is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence, risk factors, and clinical outcomes of hyperlactataemia in a cohort of HIV-infected patients.
  • To investigate the association between HL and antiretroviral therapy, specifically nucleoside reverse transcriptase inhibitors (NRTIs).

Main Methods:

  • A cohort of 140 HIV-infected patients had venous plasma lactate levels measured.
  • HL was defined as two consecutive lactate levels > 2.1 mmol/L.
  • Demographic, immuno-virological, and antiretroviral therapy data were compared between patients with and without HL.

Main Results:

  • Hyperlactataemia was found in 8.5% of patients, all receiving NRTIs.
  • Didanosine and stavudine were significantly associated with HL.
  • Discontinuation of NRTIs led to lactate level normalization in most cases.

Conclusions:

  • HL is associated with NRTI use, especially didanosine and stavudine.
  • Discontinuation of NRTIs appears to facilitate the resolution of HL.
  • Lactic acidosis is rare, and long-term outcomes for patients with HL are comparable to controls.
Abstract

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