Hyperlactatemia and concurrent use of antiretroviral therapy among HIV infected patients in Uganda

Abstract

Background: We determined the prevalence and factors associated with hyperlactatemia among HIV patients admitted on the emergency ward of a national hospital in Uganda. Objective: We were specifically interested in knowing whether there was an association between clinically significant hyperlactatemia and concurrent antiretroviral therapy (ART) use. Methods: A cross sectional descriptive study enrolled 303 HIV infected patients at a national referral hospital between March and April 2008. We consecutively recruited all eligible HIV infected patients above 18 years admitted on the emergency ward. Data were collected on socio-demographic, clinical and laboratory characteristics. Lactate levels were measured using the Accutrend® portable lactate analyser. Data analysis was performed using Stata 10.0; P-value of < 0.05 was considered to be significant. Results: Three hundred and three HIV infected patients were recruited. Prevalence of hyperlactatemia (lactate >2.5mmol/ L) was 252 (83.2%). Clinically significant hyperlactatemia (lactate >4mmol/L) was present in 105/303(34.6%) patients. There was no association between use of ART and clinically significant hyperlactatemia. In the multivariate analysis, body weakness 1.91 (1.09-3.35), skin rash 3.18 (1.11-9.10) and tachypnoea 1.04 (1.01-1.07) were independently associated with clinically significant hyperlactatemia. Conclusion: There was a high prevalence of clinically significant hyperlactatemia among HIV infected patients but it was not associated with concurrent antiretroviral use.

Antiretroviral therapy related adverse effects: Can sub-Saharan Africa cope with the new “test and treat” policy of the World Health Organization?

“…The prevalence of hyperlactatemia is very high in SSA, varying between 17.1 and 83.2% among PLWHA on ART. Once symptomatic, hyperlactatemia is associated with weakness, skin rashes, tachypnea, and can lead to death [ 9 , 13 , 40 – 42 ]. However, we recognize that this prevalence could be lower, considering that the new first line ART recommended by the WHO does include ART with a lower toxicity profile than previous regimen (removing stavudine for example).…”