Validation of A Point-of-Care Lactate Device For Screening At-Risk Adults Receiving Combination Antiretroviral Therapy In Botswana
Sikhulile Moyo1*, Hermann Bussmann1,2, Phibeon Mangwendeza1, Priti Dusara1, Tendani Gaolathe1, Madisa Mine1,3, Rosemary Musonda1,2, Erik van Widenfelt1, Vladimir Novitsky1,2, Joseph Makhema1, Richard G. Marlink1,2, Max Essex1,2 and C. William Wester1,2,4
- *Corresponding Author:
- Mr. Sikhulile Moyo Moyo
Botswana–Harvard AIDS Institute Partnership
P/Bag BO 320 Gaborone, Botswana
Tel: +267 3902671
Fax: +267 3901284
E-mail: [email protected]
Received Date: July 16, 2011; Accepted Date: August 21, 2011; Published Date: September 20, 2011
Citation: Moyo S, Bussmann H, Mangwendeza P, Dusara P, Gaolathe T, et al. (2011) Validation of A Point-of-Care Lactate Device For Screening At-Risk Adults Receiving Combination Antiretroviral Therapy in Botswana. J Antivir Antiretrovir 3: 045-048. doi: 10.4172/jaa.1000034
Copyright: ©2011 Moyo S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Nucleoside reverse-transcriptase inhibitors (NRTIs) are a major component of combination antiretroviral therapy (cART) worldwide but they have been associated with mitochondrial toxicities, with one of the most significant being lactic acidosis. In southern Africa, being female and overweight (BMI > 25) as well as receiving d4T and/or ddI-based cART are risk factors for the development of this potentially life-threatening complication. It is challenging in many resource-limited settings to obtain reliable serum lactate measurements while screening for the presence of lactic acidosis. Point-of-care devices, however, are now available that provide simple, accurate measurements of serum lactate levels at relatively low cost. The objective of this study was to assess the agreement of the portable (Accutrend™ handheld) lactate analyzer to the conventional laboratory system for obtaining serum lactate. Methods: Eighty two “at-risk” cART-treated adults were evaluated, having their lactate levels tested in parallel using both modalities. Results: The mean (range) lactate level for the portable device was 2.28 (0.9-5.0) compared to 1.96 (0.7- 5.4) using the conventional method. There was a strong correlation (p<0.05) between the portable device and the conventional means with a Pearson correlation coefficient of 0.92 [95% CI: 0.88-0.95]. The mean bias was 0.33 [95% CI: -0.39-1.04], with the portable device having slightly higher values. Conclusion: The use of a portable lactate device provides an accurate and user-friendly means of screening at-risk patients for the presence of lactic acidosis in resource-limited settings with limited laboratory capacity.