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Hyperlactatemia and Antiretroviral Therapy in the Swiss HIV Cohort Study (SHCS) K. BOUBAKER*, P. SUDRE, M. FLEPP, H-J. FURRER, A. HAENSEL, B. HIRSCHEL, K. BOGGIAN, J-P. CHAVE, E. BERNASCONI, M. OPRAVIL, M. RICKENBACH, and A. TELENTI.
The Swiss HIV Cohort Study Data Ctr., CHUV, Lausanne, Switzerland Backgroud: Hyperlactatemia is an increasingly recognized adverse event (AE) of antiretroviral therapy. The prevalence, risk factors, severity and spectrum of clinical manifestations associated with hyperlactatemia are to be defined.
Methods: During a period of 30 days (August '99) we performed a cross sectional study to determine the period-prevalence of AE among 1300 SHCS patients.
Results: Among the first 272 questionnaires, lactate above the upper normal limit (UNL) was observed in 42 (15.4%) patients. Analysis of data do not reveal any difference in term of sex, age, BMI or HIV infection stage among those with and without hyperlactatemia. 3TC and/or d4T were the most commonly prescribed anti-HIV drugs (64% of patients in the group with hyperlactatemia). 33 of 42 patients presented clinical abnormalities, the most frequent being fatigue and diarrhea. Additional laboratory abnormalities were observed in 25 of 42 patients, the most frequent being elevated urate and alteration of hepatic tests. While hyperlactatemia was mild in most cases, 6 of 42 patients presented > 2 times UNL lactate, 5 of 6 with clinical manifestations, in one case leading to ICU hospitalization.
Conclusions: Hyperlactatemia is a frequent laboratory abnormality among patients receiving antiretroviral therapy. Risk factors are being analyzed.
Key Words: adverse effects, hyperlactatemia, mitochondria
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