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  • Title: Matched case-control study to evaluate risk factors for hyperlactataemia in HIV patients on antiretroviral therapy.
    Author: Datta D, Moyle G, Mandalia S, Gazzard B.
    Journal: HIV Med; 2003 Oct; 4(4):311-4. PubMed ID: 14525541.
    Abstract:
    BACKGROUND: Lactic 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. METHODS: Cases 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. RESULTS: Twenty-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. CONCLUSIONS: The results of this case-control study indicate that, when controlling for ddI use, d4T use is an additional risk factor for hyperlactataemia.
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