| Asymptomatic hyperlactataemia: predictive value, natural history and correlates. | |
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MedLine Citation:
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PMID: 15134182 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The significance of asymptomatic hyperlactataemia is unknown. METHODS: We measured serial lactate levels in a group of HIV-infected subjects. Objectives were to identify covariates associated with hyperlactataemia, and to explore the natural history of hyperlactataemia. RESULTS: Overall, 1487 lactate measurements were performed on 396 subjects; 299 subjects had serial lactate testing, with a median of four performed per patient (range: 2-16). At study entry, lactate was >2.4 mmol/l in 6% of subjects and >3.6 mmol/l in 1%. A multiple logistic regression analysis revealed that cholesterol and current stavudine were the only predictors of hyperlactataemia. Lactate levels were highly reproducible both for short-term (within 3 months) and long-term (>1 year) follow-up. During the study period, 16 subjects were identified with sustained hyperlactataemia; 12/16 remained asymptomatic after a median of 210 days (30-585), and four developed symptoms suggestive of lactic acidosis syndrome. In three of the four, asymptomatic hyperlactataemia had preceded the onset of symptoms by 18-122 days. A longitudinal model showed a rapid rise of lactate levels from 0 to 12 months on nucleoside reverse transcriptase inhibitor (NRTI) and then stabilization. Lactate levels did not correlate with baseline or on-study development of lipoatrophy. CONCLUSIONS: Even when optimal methods of collection are used, asymptomatic hyperlactataemia does exist and could be sustained in a subset of NRTI-treated subjects for as long as 585 days. A subset of these subjects became symptomatic, after as long as 122 days of asymptomatic hyperlactataemia. Asymptomatic hyperlactataemia is not predictive of lipoatrophy. |
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Authors:
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Grace A McComsey; Linda Yau |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Antiviral therapy Volume: 9 ISSN: 1359-6535 ISO Abbreviation: Antivir. Ther. (Lond.) Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-05-11 Completed Date: 2004-06-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9815705 Medline TA: Antivir Ther Country: England |
Other Details:
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Languages: eng Pagination: 205-12 Citation Subset: IM |
Affiliation:
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Rainbow Babies and Children's Hospital, Cleveland, OH, USA. mccomsey.grace@clevelandactu.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acidosis, Lactic
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chemically induced,
diagnosis*,
physiopathology* Adult Anti-HIV Agents / adverse effects*, therapeutic use Cholesterol / blood Drug Therapy, Combination Female HIV Infections / complications*, drug therapy Humans Lactates / blood, metabolism* Longitudinal Studies Male Middle Aged Predictive Value of Tests Prospective Studies Reverse Transcriptase Inhibitors / adverse effects*, therapeutic use Stavudine / adverse effects, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents; 0/Lactates; 0/Reverse Transcriptase Inhibitors; 3056-17-5/Stavudine; 57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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