Abstract |
A case-control study was undertaken to determine risk factors for lactic acidosis in human immunodeficiency virus-infected patients treated with nucleoside reverse-transcriptase 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(-4)), and, second, a low nadir CD4+ T lymphocyte count before the inception of NRTI therapy (OR, 8.4 [range, 1.2-infinity], 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+ T lymphocyte count, could lead to modifications in antiretroviral therapy in order to diminish the risk of occurrence of lactic acidosis.
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Authors | F Bonnet, M Bonarek, P Morlat, P Mercié, M Dupon, M C Gemain, D Malvy, N Bernard, J L Pellegrin, J Beylot |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 36
Issue 10
Pg. 1324-8
(May 15 2003)
ISSN: 1537-6591 [Electronic] United States |
PMID | 12746780
(Publication Type: Journal Article)
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Chemical References |
- Reverse Transcriptase Inhibitors
- Stavudine
- Didanosine
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Topics |
- Acidosis, Lactic
(chemically induced, epidemiology)
- Adult
- Case-Control Studies
- Didanosine
(adverse effects, therapeutic use)
- Female
- HIV
- HIV Infections
(complications, drug therapy)
- Humans
- Male
- Middle Aged
- Reverse Transcriptase Inhibitors
(adverse effects, therapeutic use)
- Risk Factors
- Stavudine
(adverse effects, therapeutic use)
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