TITLE

Risk Factors for Lactic Acidosis in HIV-Infected Patients Treated with Nucleoside Reverse-Transcriptase Inhibitors: A Case-Control Study

AUTHOR(S)
Bonnet, F.; Bonarek, M.; Morlat, P.; Mercié, P.; Dupon, M.; Gemain, M.C.; Malvy, D.; Bernard, N.; Pellegrin, J.L.; Beylot, J.
PUB. DATE
May 2003
SOURCE
Clinical Infectious Diseases;5/15/2003, Vol. 36 Issue 10, p1324
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
A case-control study was undertaken to determine risk factors for lactic acidosis in human immunodeficiancy virus-infected patients treated with nucleoside reverse-tran-scriptase inhibitors (NRTIs). From May 1996 to June 2000, 9 patients with lactic acidosis (defined as a plasma lactic acid level of >5 mM and plasma pH of <7.38) were identified. Control patients were randomly selected from among a large cohort of patients who initiated a dual NRTI regimen in 1996 or after. Two factors were associated with an increased risk of lactic acidosis: first, a creatinine clearance of <70 mL/min before lactic acidosis (OR, 15.8 [range, 3.0-86.5], P < 10[SUP-4]), and, second, a low nadir CD4[SUP+]T lymphocyte count before the inception of NRTI therapy (OR, 8.4 [range, 1.2-∞], P = .03). The total cumulative exposure to NRTIs was not associated with an increased risk of lactic acidosis, nor was the cumulative exposure to any of the 4 NRTIs studied. According to these results, monitoring of creatinine clearance, especially in patients with a low nadir CD4[SUP+] T lymphocyte count, could lead to modifications in antiretroviral therapy in order to diminish the risk of occurrence of lactic acidosis.
ACCESSION #
9768979

 

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