Bonarek M, Bonnet F, Morlat P, Mercie P, Dupon M, Gemain MC, Malvy D, Dabis F, Bernard N, Pellegrin JL, Beylot J; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).

Antivir Ther. 2003; 8 (Suppl.1): abstract no. 735.

Services de Medecine Interne et Maladies Infectieuses, CHU Bordeaux, France

NRTIs, via the mitochondrial dysfunction, can result in an overproduction of lactic acid. The occurrence of a symptomatic lactic acidosis is a rare but life-threatening complication. A case-control study was implemented to determine risk factors for lactic acidosis in HIV-infected patients treated with NRTIs. From May 1996 to June 2000, nine cases of non-compensated lactic acidosis (hyperlac-tataemia >5 mmol/l and pH<7.38) were identified. Controls were randomly selected in a large cohort of patients who initiated a dual NRTIs combination from 1996. Frequency of hypothesized risk factors was tabulated for cases and controls. Relative risk estimates were calculated using the empirical odds ratio (OR). Two factors were associated with an increased risk of lactic acidosis: a creatinine clearance below 70 ml/min before lactic acidosis [OR=15.8 (3.0-86.5) P<10-4] and a low nadir of CD4+ count before the inception of NRTIs [OR=8.4 (1.20-$#165;) P=0.03]. Although a higher rate of women, hepatitis B or C co-infected patients and immunological poor responders at the end of follow-up was noticed in the group of patients with lactic acidosis, the difference was not statistically significant with the control group. The total cumulated exposure to NRTIs was not associated with an increased risk of lactic acidosis nor the cumulated exposure to each of the four NRTIs studied. According to these two new risk-factors, monitoring of creatinine clearance, specially in patients with a low CD4+ count nadir, could lead to modify anti-retroviral therapy and thus diminish the risk if occurrence of lactic acidosis.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acidosis, Lactic
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• CD4 Lymphocyte Count
• Case-Control Studies
• Control Groups
• Female
• HIV
• HIV Infections
• HIV Seropositivity
• Hepatitis B
• Humans
• Lactic Acid
• Odds Ratio
• Reverse Transcriptase Inhibitors
• Risk Factors

Other ID:

• GWAIDS0023390

UI: 102263014

From Meeting Abstracts