Factors associated with lactic acidosis in HIV patients on antiretroviral therapy in Harare city- 2012

Abstract

Introduction: Antiretroviral medicines have side effects that can be life threatening. An unpublished study by Malunga in Harare City, showed a high incidence of hyperlactatemia in patients on stalanev. This research therefore aimed to determine the proportion of HIV patients on stalanev, the burden of lactic acidosis and factors associated with developing lactic acidosis in Harare City. Methods: An analytic cross sectional study was carried out at Harare City’s Wilkins and Beatrice road hospitals. A total of 250 HIV positive participants who had been on ART for more than four months were purposively selected. In addition to interviewer administered questionnaires blood samples were analysed for lactate levels. The frequencies of hyperlactemia and lactic acidosis were determined. Risk factors were determined by multivariate logistic regression. Results: Of the 250 participants, 5.2%(13) had lactic acidosis and 29.2% (73) had hyperlactatemia. Patients on stalanev were 76% (190). Being on stalanev (p: 0.003) and having a low CD4 count of < 100cells/ml on ART initiation were found to be associated with developing lactic acidosis. Discussion: HIV patients with CD4 counts of ≤ 100 cells/μl before the inception of ART were at risk of developing lactic acidosis. Monitoring of lactate levels may be useful during management of HIV patients.