Abstract:
With the availability of Highly Active Antiretroviral Therapy (HAART), one of the
limitations of treatment safety is the occurrence of adverse events associated with
antiretroviral agents.
The aim of this study was to establish whether stavudine dosage reduction prevents
toxicity from developing and minimizes the incidence of symptomatic
hyperlactataemia/lactic acidosis (LA) in adults female HIV/AIDS infected patients.
This retrospective study covered adult patients treated at the adult ARV clinic, Dr George
Mukhari Hospital. The records of 88 patients aged between 27 and 59 years, initiated
and treated from August 2004 to January 2006, were analyzed ( 67 females and 21
males). Twenty nine females started their treatment on a regimen containing 40 mg
stavudine while 38 females were started on 30 mg stavudine. A group of male patients
(n=21) were included for comparison. Seven males started on 40 mg stavudine and 14
were on 30 mg stavudine. Ten out of twenty nine females who started treatment on 40 mg
stavudine developed elevated lactate levels while nineteen received 30 mg stavudine as
reduced dose. Eight out of nineteen further developed elevated lactate levels when on 30
mg stavudine but eleven out of nineteen remained stable on treatment with 30 mg
stavudine as reduced dose. In the group started on 30 mg stavudine, thirteen females out
of thirty seven developed elevated lactate levels while twenty four were stable on their
treatment.
Key words: stavudine, dosage reduction, lactate levels, hyperlactataemia, lactic acidosis.
