Poizot-Martin I, Marimoutou C, Bouhnik AD, Vion-Dury F, Drogoul-Vey MP, Portugal H, Gastaut JA; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. TuPeB4507.
CISIH-Sud Hopital Ste Marguerite,InsermU379, Marseille, France
BACKGROUND: Long-term treatment by antiretroviral nucleoside analogues has been demonstrated as associated to mitochondrial dysfunction and lactic acidosis which occurs with a low frequency but with a high lethal rate. Our purpose was to measure prevalence, incidence and evolution of high lactic acid measurement by a systematic screening of HIV-infected antiretroviral treated patients. METHODS: Between March 1999 and August 2000, all voluntary patients have had a baseline lactic acid measurement in resting state, repeated every three or six months. Hyper lactic acidosis (Hla+) was defined as a measurement over 2.1 I.U/ml (test threshold) and severe lactic acidosis as >5 IU/ml. RESULTS:203 patients were evaluated, 37,4% women, 30% AIDS, median of age was 38 years, viral load (VL) 204 copies/ml, CD4+ 434/mm3, median antiretroviral treatment duration 4.5 years. At baseline the median lactic acid measurement was 1.38 IU/ml [IQ: 1.02-1.86] and 17.8% (N=36) were Hla+. There was no difference in terms of demographic characteristics, CD4+ cell count, VL and proportion of co-infection by HCV but patients with Hla+ tended to be treated with same combination for shorter time and to received less frequently PI. Although, the only significant difference was higher proportion of patient receiving DDI molecule (28% vs 14%, p=0.04). Follow-up measurements (n=408) were performed in 133 (65.5%) patients, on a median period of 14 months. 24% were Hla+ at least once (n=43 Hla+ measurements), half of them being yet Hla+ at baseline. However, most measurements being <3 IU /ml and only 2 patients presented each, once a Hla+ >5 IU/ml. CONCLUSION: High level of lactic acid is frequent in HAART treated patients and often persists during follow-up, but severe lactic acidosis, at risk for clinical failure, is very rare. So, this longitudinal study does not confirm the pertinence of systematic screening of lactic acid for all antiretroviral treated patients in routine practice.
Publication Types:
Keywords:
- Acidosis, Lactic
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Didanosine
- Female
- HIV
- HIV Infections
- HIV Protease Inhibitors
- HIV-1
- Humans
- Incidence
- Lactic Acid
- Longitudinal Studies
- Prevalence
- Prognosis
- Viral Load
- epidemiology
Other ID:
UI: 102252348
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