Background: Severe hyperlactataemia and lactic acidosis are rare serious complications of antiretroviral therapy (ART).
Methods: Lactic acidosis was defined as pH 5 mmol/l. The case-control study of 110 cases and 220 controls (two randomly selected from treated patients by centre and calendar year) from centres in 10 countries included 40 (36.4%) female cases and 40 female controls (18.2%) (P
Results: After adjusting for age, gender and current CD4 cell count, hyperlactataemia/lactic acidosis remained associated with exposure to didanosine in every category of exposure duration but was most strongly associated with exposure
Interpretation: Hyperlactataemia/lactic acidosis was associated with exposure to dideoxynucleosides, female gender, advanced immunosuppression and possibly ethnicity. This has important consequences for choice of ART in resource-limited settings. The association with shorter duration of exposure may support the hypothesis of susceptibility in a small proportion of patients.
AIDS (2007) 21 (18) 2455-2464