In general, laboratory testing plays an important role in the screening and diagnosis of HIV-related metabolic and infectious diseases. A study published in 2013 suggested that HIV-infected patients received 4.5 laboratory tests per ED visit compared to 3.5 tests for the non–HIV-infected individual.8 These tests included complete blood count, basic metabolic panel, and hepatic function testing. Lactic acidosis is a complication of nucleoside reverse transcriptase inhibitor (NRTI) use and, when acutely worsened, is associated with higher mortality. Serum lactic acid measurement is appropriate in patients with an anion gap metabolic acidosis or severe illness. HIV-infected patients are not only tested more often than noninfected patients, but are admitted more frequently.8 Therefore, it appears that having a lower threshold for testing is appropriate in these patients.
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