title: Symptomatic hyperlactataemia in adults on antiretroviral therapy: a single-centre experience.
abstract: OBJECTIVE
  There are limited data on symptomatic hyperlactataemia caused by antiretroviral therapy (ART) in resource-limited settings. We assessed individuals who developed symptomatic hyperlactataemia on ART in an outpatient clinic in South Africa.
  
  
  METHODS
  A retrospective record review was performed on patients attending the clinic from January 2004 to December 2005.
  
  
  RESULTS
  Thirty-five patients, all on stavudine-containing regimens, developed symptomatic hyperlactataemia. The incidence in this population was 20.5 cases per 1 000 person-years of ART with an associated mortality of 21%. The major risk factor was being female (risk ratio (RR) 3.27). Significant clinical symptoms preceding symptomatic hyperlactataemia include nonspecific 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 hyperlactataemia. Early diagnosis expedites safe outpatient care and switching of ART regimens without interruption, in many cases.
authors.affiliation: Division of Nephrology, Department of Medicine, University of the Witwatersrand, Johannesburg. June.Fabian@wits.ac.za
authors.forename: June
authors.initials: J
authors.lastname: Fabian
authors.forename: Willem D F
authors.initials: WD
authors.lastname: Venter
authors.forename: Louisa
authors.initials: L
authors.lastname: Mkhabela
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Levin
authors.forename: Lee
authors.initials: L
authors.lastname: Baker
authors.forename: Saraladevi
authors.initials: S
authors.lastname: Naicker
mesh_terms: D000140:Acidosis, Lactic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D013019:South Africa
chemical_list: D044966:Anti-Retroviral Agents; D019344:Lactic Acid