title: Hyperlactatemia in a group of HIV patients living in Yaounde-Cameroon.
abstract: OBJECTIVE
  Prolonged exposure to highly active antiretroviral therapy (HAART) is associated with adverse effects such as hyperlactatemia. We determined the prevalence and risk factors for developing hyperlactatemia among human immunodeficiency virus (HIV)-infected cameroonians on antiretroviral therapy (ART).
  
  
  METHODS
  We conducted a cross-sectional study from January to April 2012 involving 91 HIV-infected patients receiving ART for at least 12 months and 30 HIV-infected patients who have never received ART (ART-naïve patients). Plasma lactate levels were determined after at least 12 hours of overnight fasting and hyperlactatemia defined as lactate concentrations ≥ 3 mmol/L. The prevalence of hyperlactatemia was determined and the risk factors were analyzed by a multivariate logistic regression model.
  
  
  RESULTS
  The mean lactataemia was significantly higher in the group of HIV patients currently taking ART than in the ART-naïve one (2.3 ± 1.3 and 1.7 ± 0.7 mmol/L respectively, p = 0.002). Patients on first line ART regimens had significantly higher lactatemia than those on second line regimens (2.5 ± 1.5 and 1.9 ± 0.7 mmol/L respectively, p = 0.014). The prevalence of hyperlactatemia in HIV patients receiving ART and in ART-naïve HIV patients was respectively 18.7 and 6.7% (p = 0.095). ART-exposure (adjusted odds ratio (aOR) 5.44, 95% confidence interval (CI) 1.06 - 27.84; p = 0.042) and being on a first line regimen (aOR 16.22, 95% CI 1.57 - 167.91; p = 0.019) were independent strong predictors of hyperlactatemia.
  
  
  CONCLUSIONS
  Hyperlactatemia was not rare in our study population. Being on a first line regimen constitutes an important risk factor for developing hyperlactatemia. Measurement of plasma lactate may be useful in optimizing the management of HIV-positive persons on ART.
authors.forename: Corinne Tchoula
authors.initials: CT
authors.lastname: Mamiafo
authors.affiliation: Laboratory of Biochemistry, Yaounde University Teaching Hospital, Yaounde, Cameroon. movicky@yahoo.fr.
authors.forename: Vicky Jocelyne Ama
authors.initials: VJ
authors.lastname: Moor
authors.forename: Jobert Richie N
authors.initials: JR
authors.lastname: Nansseu
authors.forename: Constant Anatole
authors.initials: CA
authors.lastname: Pieme
authors.forename: Claude
authors.initials: C
authors.lastname: Tayou
authors.forename: Jeanne Ngogang
authors.initials: JN
authors.lastname: Yonkeu