Original articles

Symptomatic hyperlactataemia in adults on anti-retroviral therapy: A single centre experience

June Fabian, Willem Daniel Francois Venter, Louisa Mkhabela, Jonathan B Levin, Lee Baker, Saraladevi Naicker


Objectives: There is little data on symptomatic hyperlactataemia due to antiretroviral therapy (ART) in resource-limited settings. This retrospective record review assessed individuals who developed symptomatic hyperlactataemia on ART in an outpatient clinic in South Africa.

Design: A retrospective record review was performed on patients attending the clinic from January 2004 to December 2005.

Results: 35 patients developed symptomatic hyperlactataemia, all on stavudine-containing regimens. The incidence in this population was 20.5 cases per 1000 person-years of ART with an associated mortality of 21%. The major risk factor was being female (RR 3.27). Significant clinical symptoms preceding symptomatic hyperlactataemia include non-specific gastrointestinal symptoms, weight loss, and development of symptomatic neuropathy

Conclusions: The incidence of symptomatic hyperlactataemia in our population was high. Simple clinical measures, such as neuropathy symptoms and monitoring of weight may alert the clinician to impending symptomatic hyperlacataemia. Early diagnosis allows for safe outpatient care, and for switching of ART regimens without interruption in many cases.

Authors' affiliations

June Fabian, Division of Nephrology, Department of Medicine, University of the Witwatersrand

Willem Daniel Francois Venter, Reproductive Health and HIV Research Unit, University of the Witwatersrand

Louisa Mkhabela, HIV Clinic, Johannesburg Hospital, Gauteng Department of Health

Jonathan B Levin, Biostatistics Unit, Medical Research Council of South Africa

Lee Baker, Amayeza (Medicines) Information Services

Saraladevi Naicker, Division of Nephrology, Department of Medicine, University of the Witwatersrand

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HIV; lactic acidosis; antiretroviral therapy

Cite this article

South African Medical Journal 2008;98(10):795.

Article History

Date submitted: 2007-09-20
Date published: 2008-10-08

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