Risk factors for and clinical characteristics of severe hyperlactataemia in patients receiving antiretroviral therapy: a case-control study.

摘要: Background Symptomatic hyperlactataemia and lactic acidosis (SHLA) are potentially life-threatening complications associated with stavudine (d4T), an antiretroviral therapy (ART) drug widely used in developing countries. Methods Cases comprised all symptomatic patients measured lactates ≥5 mmol/L referred to a South African hospital between August 2003 November 2005. Matched controls were selected according facility duration on ART. Results Seventy-one cases 142 included the study. The majority of presented 6 18 months ART. Female sex [adjusted odds ratio (AOR) 23.4; 95% confidence interval (CI) 4.0–136.6], baseline weight 60 75 kg (AOR 4.5; CI 1.4–14.1) or, particular, ≥75 kg 19.4; 4.1–82.5) at ART initiation gaining ≥6 kg first 3 3.5; 1.3–9.5) independent risk factors identifying who may subsequently develop SHLA. Weight loss ≥2 kg 6.1; 2.0–18.3), rise alanine aminotransferase (ALT) ≥10 U/L 3.1; 1.1–8.9), presence least one three major symptoms (vomiting, nausea abdominal pains) SHLA 12.6; 3.3–47.2) peripheral neuropathy 3.4; 1.1–9.8) clinical parameters that most able identify early manifestations SHLA. Conclusions This is case–control study for Southern Africa. Given these findings, we advise avoided overweight women. loss, ALT, and/or gastrointestinal should prompt healthcare workers assess SHLA, especially