title: Co-factors for abnormal lactate levels among persons with HIV disease at a tertiary HIV care setting in South India.
abstract: BACKGROUND
  The co-factors underlying abnormal lactate level remains to be determined in resource-limited settings. In a cross-sectional study conducted between January 2004 and July 2006, we determined the proportion of HIV-infected persons with abnormal lactate levels and correlated the association of certain co-factors of abnormal lactate levels at a tertiary HIV care centre in Chennai, Southern India.
  
  
  METHODS
  Lactate was estimated by the enzymatic method using an Olympus AU 400 autoanalyzer. Absolute CD4+T lymphocyte count was determined by the Guava personal cell analyser (Guava Technologies Inc., Hayward, CA, USA). Subjects were classified to have normal or abnormal values of lactate based on the reference interval (0.3-2.2 mmol/L). A p value 0.05 was considered statistically significant.
  
  
  RESULTS
  A total of 225 HIV-infected individuals (HAART experienced 213 (95%) and HAART naïve (5%)) were included in the analysis. Mean age was 34+/-8 and 36+/-9 years for the individuals with normal and abnormal lactate levels respectively. Of these 185 (82%) had normal (0.3-2.2 mmol/L) and 40 (18%) had abnormal (>2.2 mmol/L) lactate levels. Significant difference in relation to female gender was observed between the normal and abnormal groups (p=0.03). Among the abnormal group, 39 (97.5%) subjects were HAART experienced compared to 174 (94.1%) normal group. Among the abnormal group, 24 (60%) individuals had a CD4 count of <200 cells/microL as compared to 76 (41.1%) normal subjects.
  
  
  CONCLUSIONS
  Female gender should be carefully monitored with respect to their clinical, laboratory and biological data to diminish the occurrence of lactic acidosis.
authors.affiliation: YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services, Rajiv Gandhi Salai, Chennai 600 113, India.
authors.forename: Muthu
authors.initials: M
authors.lastname: Sundaram
authors.forename: Chakravarthy Narasimhachar
authors.initials: CN
authors.lastname: Srinivas
authors.forename: Esaki Muthu
authors.initials: EM
authors.lastname: Shankar
authors.forename: Manohar
authors.initials: M
authors.lastname: Deepak
authors.forename: Kailapuri G
authors.initials: KG
authors.lastname: Murugavel
authors.forename: Pachamuthu
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood* / Q000150:complications; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications; D006801:Humans; D007194:India; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D012727:Sex Characteristics
chemical_list: D019344:Lactic Acid