Severe Hyperlactataemia Complicating Stavudine First-Line Antiretroviral Therapy in South Africa
| Autor: | Stead D, Osler M, Boulle A, Rebe K, Graeme Meintjes |
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| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | Scopus-Elsevier Europe PubMed Central |
| ISSN: | 2040-2058 1359-6535 |
| DOI: | 10.1177/135965350801300712 |
| Popis: | Background In the public sector antiretroviral therapy (ART) programme in South Africa the standardized first-line regimen includes stavudine (d4T). Severe symptomatic hyperlactataemia (SHL) is a potentially life- threatening complication of d4T. Methods GF Jooste Hospital is a referral centre for six ART clinics. We retrospectively reviewed cases referred with lactate levels ≥5 mmol/l that were attributed to nucleoside reverse transcriptase inhibitors from August 2003 to November 2005. We calculated cumulative ART exposure in patients attending these clinics to derive a referral rate. Results In total, 75 patients were referred with severe SHL (71 female). All had been on d4T and on ART for a median of 10 months. The referral rate for severe SHL was 17.5 cases per 1,000 patient-years. In 53 patients (71%), lactic acidosis (standard bicarbonate [SHCO3]3Conclusions This study confirms a high incidence of severe SHL in Africa, which has been shown in previous studies. Rechallenge with zidovudine in less severe cases was found to be safe. |
| Databáze: | OpenAIRE |
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