Asymptomatic hyperlactataemia: predictive value, natural history and correlates.

Area of Science:

• Biomedical research
• HIV/AIDS medicine
• Metabolic disorders

Background:

• The clinical significance of asymptomatic hyperlactataemia in HIV-infected individuals remains unclear.
• Understanding the implications of elevated lactate levels without symptoms is crucial for patient management.

Purpose of the Study:

• To identify factors associated with hyperlactataemia in HIV patients.
• To investigate the natural progression of asymptomatic hyperlactataemia.

Main Methods:

• Serial lactate level measurements were conducted in a cohort of HIV-infected subjects.
• Statistical analyses, including multiple logistic regression and longitudinal modeling, were employed.

Main Results:

• Cholesterol and stavudine use were identified as predictors of hyperlactataemia.
• Sustained hyperlactataemia was observed in 16 subjects, with 12 remaining asymptomatic for up to 585 days.
• Four subjects developed symptoms suggestive of lactic acidosis syndrome, preceded by asymptomatic hyperlactataemia.

Conclusions:

• Asymptomatic hyperlactataemia can be sustained in a subset of nucleoside reverse transcriptase inhibitor (NRTI)-treated subjects.
• A portion of individuals with asymptomatic hyperlactataemia may progress to symptomatic disease.
• Asymptomatic hyperlactataemia was not found to predict lipoatrophy.