High Risk for Hyperlactatemia and Lactic Acidosis in Women Taking d4T

Treatment with d4T has been associated with hyperlactatemia and lactic acidosis, especially in women. Although no longer recommended as part of first-line treatment in developed countries, d4T is still used in the public sector in South Africa, where the majority of the HIV-infected population is female. To evaluate the incidence of hyperlactatemia and lactic acidosis, researchers conducted a retrospective cohort analysis among 1735 adults (63% women) who initiated potent combination antiretroviral therapy (ART) at a Soweto, South Africa, HIV clinic from April 2004 through August 2005. All patients were followed through February 2006.

During the study period, 23 patients — 22 of them women — experienced lactic acidosis (i.e., lactate level >…