Sixth International Congress Drug Therapy in HIV Infection 17-21 November, 2002 Glasgow, UK

Purpose of the study: Prognosis of lactic acid (LA) increase is still uncertain. While asymptomatic elevation is thought to be of little significance, lactic acidosis still has a high mortality. Our objective was to determine kinetics of LA in order to test whether the metabolic capacity of lactate degradation is influenced by HAART and baseline LA levels.

Methods: HIV negative controls (C n=10), HAART-naïve patients (NP n=7), patients on HAART with normal baseline LA (NLA n=12), and patients on HAART with LA higher than 2 mmol/l (HLA n=7) were tested. Exercise was performed for ten minutes with a heart rate of 200 minus age under ECG monitoring. Lactate levels were taken at baseline, at the end of exercise, and at time points 15, 30, 45, 60 and 120 minutes thereafter.

Summary of results: Average baseline LA was 1.4, 1.5, 1.6, and 2.8 mmol/l in the four groups (C, NP, NLA, and HLA). Maximum LA after exercise was 9.7; 10.3, 9.3, and 10.5 showing similar exercise levels in all four groups. Decline of LA in % of maximum after the first 15 minutes was 60.8, 46.0, 40.7 and 36.5% (p<0.05 between C and all HIV groups). Significant differences were found in the slope of LA decline between NLA and HLA and between C and NP (p<0.05).

Conclusions: Conclusions Our results show that differences in LA metabolism do exist between HIV negative and HIV positive therapy naïve persons. Thus HIV infection by itself may influence LA. On the other hand, elevated baseline LA does result in a prolonged decline of LA after exercise.

Presenting author: Johannes Bogner

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1 University Hospital Munich, Medizinische Poliklinik, Department of Infectious Diseases, Munich, Germany

2002-11-17
PL14-2

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