Validation of the Accutrend® lactate meter for hyperlactatemia screening during antiretroviral therapy in a resource-poor setting

Summary Background: The use of highly active antiretroviral therapy (HAART) results in multiple side effects that may jeopardize the life of the patient being treated with antiretroviral drugs. In resource-poor settings it is difficult to definitively diagnose lactic acidosis by laboratory measurement of lactate. Point-of-care (POC) devices are helpful in the measurement of lactate levels and have been validated in the intensive care unit setting, but not in a busy outpatient clinic. The objective of this study was to assess the sensitivity and specificity of the Accutrend 1 lactate meter in the diagnosis of hyperlactatemia/lactic acidosis in patients on nucleoside reverse transcriptase inhibitor (NRTI)-containing regimens (stavudine). Design and methods: This was a cross-sectional study of 120 patients on HAART (lamivudine, stavudine, efavirenz, or nevirapine) with symptoms of/or recovering from hyperlactatemia/ lactic acidosis. Simultaneous testing of the same blood sample was undertaken on the Accutrend 1 handheld lactate analyzer and a reference instrument (Beckman CX7 Synchron 1