Macrocytosis is a predictor of resting lactate concentrations in persons on dideoxynucleoside therapy for HIV infection.
OBJECTIVE
Mitochondrial toxicity is an important toxicity of antiretroviral therapy and may manifest as elevated blood lactate. Macrocytosis has been hypothesized to act as a marker of mitochondrial toxicity in persons with HIV infection. As part of a larger study on markers of mitochondrial toxicity we evaluated the relationship between resting lactate and erythrocyte mean corpuscular volume (MCV).


METHODS
We studied the effect of micronutrient supplementation on lactate metabolism in three groups: those with HIV on and not on dideoxynucleoside-containing antiretroviral therapy and those without HIV. As part of the study we measured resting lactate and erythrocyte MCV after a 14-h fast.


RESULTS
Erythrocyte MCV was significantly higher among the 11 participants on antiviral therapy (109.3 femtoliters (fl)) compared to five controls without HIV (89.3 fl) and four controls with HIV not on antiviral therapy (88.3 fl). In addition a strong predictive relationship was seen between MCV and resting lactate (R(2)=0.548, p<0.01).


CONCLUSIONS
Macrocytosis may be a marker of treatment-related mitochondrial dysfunction in persons on treatment for HIV. Evaluating patients for early evidence of mitochondrial dysfunction in resource-constrained settings could be facilitated by this marker.
Department of Medicine, Queen's University, Kingston, Ontario, K7L 3N6, Canada. wendy.wobeser@queensu.ca
Wendy
W
Wobeser
Erin
E
Morgan
Amir
A
Rumman
Peter Michael
PM
Ford
D000328:Adult; D000748:Anemia, Macrocytic / Q000097:blood / Q000139:chemically induced*; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D048429:Cell Size / Q000187:drug effects; D015224:Dideoxynucleosides / Q000009:adverse effects* / Q000627:therapeutic use; D004909:Erythrocyte Indices / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged
D019380:Anti-HIV Agents; D015415:Biomarkers; D015224:Dideoxynucleosides; D019344:Lactic Acid