Fabian June, Venter Willem D F, Mkhabela Louisa, Levin Jonathan B, Baker Lee, Naicker Saraladevi
Division of Nephrology, Department of Medicine, University of the Witwatersrand, Johannesburg.
S Afr Med J. 2008 Oct;98(10):795-800.
There are limited data on symptomatic hyperlactataemia caused by antiretroviral therapy (ART) in resource-limited settings. We assessed individuals who developed symptomatic hyperlactataemia on ART in an outpatient clinic in South Africa.
A retrospective record review was performed on patients attending the clinic from January 2004 to December 2005.
Thirty-five patients, all on stavudine-containing regimens, developed symptomatic hyperlactataemia. The incidence in this population was 20.5 cases per 1 000 person-years of ART with an associated mortality of 21%. The major risk factor was being female (risk ratio (RR) 3.27). Significant clinical symptoms preceding symptomatic hyperlactataemia include nonspecific gastrointestinal symptoms, weight loss, and development of symptomatic neuropathy.
The incidence of symptomatic hyperlactataemia in our population was high. Simple clinical measures, such as neuropathy symptoms and monitoring of weight, may alert the clinician to impending symptomatic hyperlactataemia. Early diagnosis expedites safe outpatient care and switching of ART regimens without interruption, in many cases.
在资源有限的环境中，关于抗逆转录病毒疗法（ART）引起的症状性高乳酸血症的数据有限。我们对南非一家门诊诊所中接受ART治疗后出现症状性高乳酸血症的个体进行了评估。
对2004年1月至2005年12月在该诊所就诊的患者进行了回顾性记录审查。
35名患者均采用含司他夫定的治疗方案，出现了症状性高乳酸血症。该人群中ART治疗的发病率为每1000人年20.5例，相关死亡率为21%。主要危险因素为女性（风险比（RR）3.27）。症状性高乳酸血症出现之前的显著临床症状包括非特异性胃肠道症状、体重减轻和症状性神经病变的发生。
我们人群中症状性高乳酸血症的发病率很高。简单的临床措施，如神经病变症状和体重监测，可能会提醒临床医生注意即将出现的症状性高乳酸血症。早期诊断可加快安全的门诊治疗，并在许多情况下无间断地更换ART治疗方案。
