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Romero-Cordero S, Noguera-Julian A, Cardellach F, Fortuny C, Morén C. Mitochondrial changes associated with viral infectious diseases in the paediatric population. Rev Med Virol 2021; 31:e2232. [PMID: 33792105 PMCID: PMC9286481 DOI: 10.1002/rmv.2232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/24/2022]
Abstract
Infectious diseases occur worldwide with great frequency in both adults and children, causing 350,000 deaths in 2017, according to the latest World Health Organization reports. Both infections and their treatments trigger mitochondrial interactions at multiple levels: (i) incorporation of damaged or mutated proteins into the complexes of the electron transport chain; (ii) impact on mitochondrial genome (depletion, deletions and point mutations) and mitochondrial dynamics (fusion and fission); (iii) membrane potential impairment; (iv) apoptotic regulation; and (v) generation of reactive oxygen species, among others. Such alterations may result in serious adverse clinical events with considerable impact on the quality of life of the children and could even cause death. Herein, we use a systematic review to explore the association between mitochondrial alterations in paediatric infections including human immunodeficiency virus, cytomegalovirus, herpes viruses, various forms of hepatitis, adenovirus, T-cell lymphotropic virus and influenza. We analyse how these paediatric viral infectious processes may cause mitochondrial deterioration in this especially vulnerable population, with consideration for the principal aspects of research and diagnosis leading to improved disease understanding, management and surveillance.
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Affiliation(s)
- Sonia Romero-Cordero
- Faculty of Medicine, Pompeu Fabra University, Barcelona, Spain.,Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d´Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.,Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP (ISCIII), Madrid, Spain.,Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
| | - Francesc Cardellach
- Faculty of Medicine and Health Sciences, Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS, University of Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, CIBERER (ISCIII), Madrid, Spain.,Internal Medicine Department, Hospital Clínic of Barcelona (HCB), Barcelona, Spain
| | - Clàudia Fortuny
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d´Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.,Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP (ISCIII), Madrid, Spain.,Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
| | - Constanza Morén
- Faculty of Medicine and Health Sciences, Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS, University of Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, CIBERER (ISCIII), Madrid, Spain.,Internal Medicine Department, Hospital Clínic of Barcelona (HCB), Barcelona, Spain
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Abstract
OBJECTIVE Hepatitis C virus (HCV), cirrhosis, and HCV medications including direct-acting antivirals (DAAs) ±ribavirin may all influence the metabolic milieu. While interferon-based regimens improve glucose tolerance, evidence is limited on DAAs. Cases of elevated lactate have recently been reported in patients treated with DAAs, and lactic acidosis is a known complication of antivirals used to treat hepatitis B virus and HIV. PATIENTS AND METHODS Measures were evaluated at baseline, week 4, end of treatment, and 12-24 weeks after treatment. Mixed-effects modeling was used to determine factors influencing glucose and lactate over time. RESULTS In total, 442 patients were treated (mean age 56, 65% male, 72% genotype 1, 48% cirrhotic). Glucose did not change on or after DAA treatment from baseline (P=0.51) aside from those with untreated diabetes, which declined (P=0.02). Overall, there was a decline in lactate following HCV treatment (mean 2.4-2.1 mmol/l; P<0.001). Lactate initially increased on treatment and then decreased after treatment completion in male patients treated with ribavirin. This pattern was not observed in other groups. There was no evidence of lactic acidosis with HCV nucleotide use. CONCLUSION Distinct glucose and lactate trajectories were identified without evidence of DAA metabolic toxicity. HCV treatment does not improve random glucose levels aside from perhaps in untreated diabetic patients.
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Abstract
Few modern diseases have experienced as rapid and dramatic change in prognosis and treatment as HIV infection. The introduction of active antiretroviral therapy (ART) and effective prophylaxis of opportunistic infections ushered in a new era in the treatment of HIV infection and changed dramatically the natural history of this disease. The rates of admission to the intensive care unit (ICU) and intensive care mortality in patients with HIV infection have shifted repeatedly during the AIDS epidemic, influenced by attitudes of patients and providers toward utility of care. In the ART era, patients with HIV infection admitted to the ICU fall into 3 general categories: those with AIDS-related opportunistic infections, those who are experiencing complications related to ART, and those with medical problems unrelated to HIV infection. In this article, the authors provide a review of the most common life-threatening complications in patients with HIV infection.
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Affiliation(s)
- Raul E Davaro
- UMass Memorial Health Care, Worcester, MA 01605, USA.
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Welker MW, Luhne S, Lange CM, Vermehren J, Farnik H, Herrmann E, Welzel T, Zeuzem S, Sarrazin C. Lactic acidosis in patients with hepatitis C virus cirrhosis and combined ribavirin/sofosbuvir treatment. J Hepatol 2016; 64:790-9. [PMID: 26658684 DOI: 10.1016/j.jhep.2015.11.034] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 11/12/2015] [Accepted: 11/23/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Sofosbuvir (SOF) based interferon-alfa free antiviral therapy has become the treatment of choice for patients with chronic hepatitis C virus (HCV) infection. Little is known about safety of drug combinations using two nucleos(t)ide polymerase inhibitors in patients with HCV associated advanced cirrhosis. Here, we report frequent occurrence of lactic acidosis associated with acute-on-chronic hepatic decompensation during ribavirin (RBV) plus SOF based antiviral therapy. METHODS Thirty-five patients with chronic hepatitis C and advanced fibrosis, compensated cirrhosis, and decompensated cirrhosis without and after liver transplantation were treated with SOF based antiviral therapy with and without RBV. Adverse events including lactic acidosis (pH <7.35, lactate >20 mg/dl) were recorded 24 weeks before and during (mean ±SD, 18±11 weeks) antiviral therapy. Efficacy was determined by assessment of serum HCV RNA. RESULTS We observed severe adverse events in 15/35 (43%) patients before (24 weeks) and in 12/35 (34%) patients during antiviral therapy, the majority in association with acute-on-chronic hepatic decompensation. Lactic acidosis occurred in 5/35 (14%) patients during therapy, while no event of lactic acidosis was observed prior to therapy. Lactic acidosis was associated with hepatic decompensation including renal failure and infection, and was severe (pH <7.3) in two patients. CONCLUSIONS RBV in combination with SOF based antiviral therapy in patients with HCV associated advanced cirrhosis may be associated with the development of lactic acidosis. Impaired renal function, and higher MELD/Child-Pugh scores were identified as potential risk factors.
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Affiliation(s)
- Martin-Walter Welker
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
| | - Stefan Luhne
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Christian M Lange
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Johannes Vermehren
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Harald Farnik
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Eva Herrmann
- Institut für Biostatistik und Mathematische Modellierung, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Tania Welzel
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Stefan Zeuzem
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Christoph Sarrazin
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
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Paes LDS, Borges JP, dos Santos FM, de Oliveira TP, Dupin JG, Harris EA, Farinatti P. Effects of a 2-Year Supervised Exercise Program Upon the Body Composition and Muscular Performance of HIV-Infected Patients. Open AIDS J 2015; 9:80-8. [PMID: 26587076 PMCID: PMC4645897 DOI: 10.2174/1874613601509010080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/08/2015] [Accepted: 08/16/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a lack of research investigating long-term effects of exercise training upon the body composition and muscle function in HIV-infected patients (PHIV). The study investigated the influence of a 2-year supervised exercise program on body composition and strength of PHIV under highly active antiretroviral therapy (HAART). METHODS A training program including aerobic, strength and flexibility exercises was performed by 27 PHIV (17 men/ 10 women; age: 48.7±7.0 years; HAART: 150.7±65.3 months) during 1 year and 18 PHIV (10 men/ 8 women; age: 50.6±5.2 years; HAART: 176.6±53.1 months) during 2 years. Body composition and knee isokinetic strength were assessed at baseline and at the end of each year of intervention. RESULTS Body composition remained stable along the whole experiment vs baseline (1-year - total muscle mass: Δ men=1.1%, P=0.21; Δ women=1.4%, P=0.06; trunk fat: Δ men=-0.1%, P=0.65; Δ women=-1.5%, P=0.45; 2 years - total muscle mass: Δ men=2.7%, P=0.54; Δ women=-1.9%, P=0.71; trunk fat: Δ men=4.4%, P=0.96; Δ women=10.0%, P=0.30). After 1-year, peak torque increased in men (Δ extension=4.2%, P=0.01; Δ flexion=12.2%, P=0.04) and total work reduced in women (Δ extension=-15.4%, P=0.01, Δ flexion=-17.5%, P=0.05). All strength markers remained stable vs baseline after 2 years of intervention (P>0.05). Only men showed significant reduction in the risk of disability due to sarcopenia (P=0.05) after 1 year of intervention, which remained stable after 2 years. CONCLUSION Long-term exercise training preserved strength and muscle mass in PHIV under HAART. Exercise programs should be part of HIV therapy to prevent sarcopenia of this population along the years. TRIAL REGISTRATION ACTRN12610000683033; UTN U1111-1116-4416.
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Affiliation(s)
- Lorena da Silva Paes
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Fernanda Monteiro dos Santos
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Taciana Pinto de Oliveira
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Jaciara Gomes Dupin
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Elizabeth Assumpção Harris
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
- Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, RJ, Brazil
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Feeney ER, Chazallon C, O'Brien N, Meiffrédy V, Goodall RL, Aboulker JP, Cooper DA, Yeni P, Mallon PWG. Hyperlactataemia in HIV-infected subjects initiating antiretroviral therapy in a large randomized study (a substudy of the INITIO trial). HIV Med 2011; 12:602-9. [PMID: 21599820 DOI: 10.1111/j.1468-1293.2011.00934.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the predictive value of clinical and molecular risk factors, including peripheral blood mononuclear cell (PBMC) mitochondrial DNA (mtDNA) and mitochondrial RNA (mtRNA), for the development of lactic acidosis (LA) and symptomatic hyperlactataemia (SHL). METHODS In a substudy of a large multicentre, randomized trial of three antiretroviral regimens, all containing didanosine (ddI) and stavudine (d4T), in antiretroviralnaïve, HIV-1-infected patients, patients with LA/SHL ('cases') were compared with those without LA/SHL in a univariate analysis, with significant parameters analysed in a multivariate model. In a molecular substudy, PBMC mtDNA and mtRNA from cases and matched controls at baseline and time of event were examined. RESULTS In 911 subjects followed for a median of 192 weeks, 24 cases were identified (14 SHL and 10 LA). In univariate analysis, cases were more likely to be female (P=0.05) and to have a high body mass index (BMI) (P=0.02). In multivariate analyses, only BMI remained an independent predictor of the development of LA/SHL (P=0.03). Between cases and controls there was no significant difference in mtDNA copy number at baseline (389 vs. 411 copies/cell, respectively; P=0.60) or at time of event (329 vs. 474 copies/cell, respectively; P=0.21), in the change in mtDNA copy number from baseline to event (-65 vs. +113 copies/cell, respectively; P=0.12), in mtRNA expression at baseline or time of event, or in the change in mtRNA expression from baseline to event. CONCLUSION The development of LA/SHL was associated with increased BMI, but PBMC mtDNA and mtRNA did not predict LA/SHL. This demonstrates the ineffectiveness of routine measurement of PBMC mtDNA in patients on ddI and d4T as a means of predicting development of LA/SHL.
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Affiliation(s)
- E R Feeney
- HIV Molecular Research Group, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
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Chapplain JM, Tattevin P, Guyader D, Begue JM, Beillot J, Turlin B, Souala F, Arvieux C, Rochcongar P, Michelet C. Mitochondrial abnormalities in patients with HIV-HCV co-infection as compared to patients with HCV mono-infection. HIV CLINICAL TRIALS 2011; 12:54-60. [PMID: 21388941 DOI: 10.1310/hct1201-54] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Mitochondrial dysfunction is a classic complication of HIV infection and its treatment and has also been reported in hepatitis C virus (HCV)-infected patients. Little is known about interactions between both viruses on mitochondrial metabolism. METHODS We performed a cross-sectional study of HCV-infected patients who underwent liver biopsy as part of their routine care. Mitochondrial function was assessed by (a) liver morphological (histology) and functional (spectro-photometry) studies, and (b) serum lactate kinetics, oxygen uptake, and anaerobic threshold measurement during standardized incremental exercise. Three predefined groups of patients were compared. RESULTS Thirty-eight HCV-infected patients were included: 13 not HIV infected (group 1), 7 with HIV co-infection and low nucleoside reverse transcriptase inhibitor (NRTI) exposure (none over the last 2 years; group 2), and 18 with HIV co-infection and high NRTI exposure (group 3). On liver biopsies, respiratory chain complex IV activity was impaired, at 5 (2-7) nmol/min/mg substrates in group 1, 5 (3-8) in group 2, and 8 (2-13) in group 3 (normal values, 20-56). Maximal power output was diminished and anaerobic threshold occurred earlier in HIV-infected patients, regardless of NRTI exposure. CONCLUSION HCV has deleterious effects on liver mitochondrial metabolism, notably on respiratory chain complex IV. No significant interaction with HIV was observed.
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Curran A, Ribera E. From old to new nucleoside reverse transcriptase inhibitors: changes in body fat composition, metabolic parameters and mitochondrial toxicity after the switch from thymidine analogs to tenofovir or abacavir. Expert Opin Drug Saf 2011; 10:389-406. [PMID: 21235431 DOI: 10.1517/14740338.2011.542145] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Thymidine analogs zidovudine (AZT) and stavudine (d4T) have been widely used because of their antiviral activity against HIV, but at the expense of high toxicity, mainly related to mitochondrial damage. Many studies have been performed replacing AZT or d4T with newer nucleoside analogs reverse transcriptase inhibitors (NRTIs) with less toxicity, such as tenofovir (TDF) or abacavir (ABC), maintaining virological efficacy. AREAS COVERED Relevant literature was identified using a PubMed search of articles published up to June 2010. Search terms included: 'thymidine analogs', 'stavudine', 'zidovudine', 'd4T', 'AZT', 'ZDV', 'treatment switch'. Original articles in which d4T or AZT had been replaced by TDF or ABC as switch strategies (with undetectable viral load) were reviewed where information about body fat distribution, mitochondrial functionality and/or plasma lipid parameters were available. Relevant references from these articles were also considered. Only studies performed in adult patients (18 years or older) are included. The readers will gain a better understanding of the toxicity caused by thymidine analogs, the treatment alternatives and the benefits observed after treatment switch to newer NRTIs. EXPERT OPINION Thymidine analogs AZT and d4T yield considerable toxicity and proactive switch to newer NRTIs such as TDF or ABC is necessary in order to avoid or partially reverse such side effects.
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Affiliation(s)
- Adrian Curran
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Institut de Recerca, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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Sutinen J, Laaksonen MS, Walker UA, Setzer B, Kemppainen J, Nuutila P, Yki-Jarvinen H. Skeletal muscle mitochondrial DNA content and aerobic metabolism in patients with antiretroviral therapy-associated lipoatrophy. J Antimicrob Chemother 2010; 65:1497-504. [DOI: 10.1093/jac/dkq138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Oursler KK, Katzel LI, Smith BA, Scott WB, Russ DW, Sorkin JD. Prediction of cardiorespiratory fitness in older men infected with the human immunodeficiency virus: clinical factors and value of the six-minute walk distance. J Am Geriatr Soc 2009; 57:2055-61. [PMID: 19793156 DOI: 10.1111/j.1532-5415.2009.02495.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate factors related to cardiorespiratory fitness in older human immunodeficiency virus (HIV)-infected patients and to explore the utility of 6-minute walk distance (6-MWD) in measuring fitness. DESIGN Cross-sectional study in clinic-based cohort. SETTING Veterans Affairs Medical Center, Baltimore, Maryland. PARTICIPANTS Forty-three HIV-infected men, median age 57 (range 50-82), without recent acquired immunodeficiency syndrome-related illness and receiving antiretroviral (ARV) therapy. MEASUREMENTS Peak oxygen utilization (VO(2)peak) according to treadmill graded exercise testing, 6-MWD, grip strength, quadriceps maximum voluntary isometric contraction, cross-sectional area, muscle quality, and muscle adiposity. RESULTS There was a moderate correlation between VO(2)peak (mean +/- SD; 18.4 +/- 5.6 mL/kg per minute) and 6-MWD (514 +/- 91 m) (r=0.60, P<.001). VO(2)peak was lower in subjects with hypertension (16%, P<.01) and moderate anemia (hemoglobin 10-13 gm/dL; 15%, P=.09) than in subjects without these conditions. CD4 cell count (median 356 cells/mL, range 20-1,401) and HIV-1 viral load (84% nondetectable) were not related to VO(2)peak. Among muscle parameters, only grip strength was an independent predictor of VO(2)peak. Estimation of VO(2)peak using linear regression, including age, 6-MWD, grip strength, and hypertension as independent variables, explained 61% of the variance in VO(2)peak. CONCLUSION Non-AIDS-related comorbidity predicts cardiorespiratory fitness in older HIV-infected men receiving ARV therapy. The 6-MWD is a valuable measure of fitness in this patient population, but a larger study with diverse subjects is needed.
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Affiliation(s)
- Krisann K Oursler
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland 21201, USA.
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Mitochondrial DNA haplogroups influence lipoatrophy after highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2009; 51:111-6. [PMID: 19339895 DOI: 10.1097/qai.0b013e3181a324d6] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although highly active antiretroviral therapy (HAART) has been extremely effective in lowering AIDS incidence among patients infected with HIV, certain drugs included in HAART can cause serious mitochondrial toxicities. One of the most frequent adverse events is lipoatrophy, which is the loss of subcutaneous fat in the face, arms, buttocks, and/or legs as an adverse reaction to nucleoside reverse transcriptase inhibitors. The clinical symptoms of lipoatrophy resemble those of inherited mitochondrial diseases, which suggest that host mitochondrial genotype may play a role in susceptibility. We analyzed the association between mitochondrial haplogroup and severity of lipoatrophy in HIV-infected European American patients on HAART in the Multicenter AIDS cohort Study and found that mitochondrial haplogroup H was strongly associated with increased atrophy [arms: P = 0.007, odds ratio (OR) = 1.77, 95% confidence interval (CI) = 1.17 to 2.69; legs: P = 0.037, OR = 1.54, 95% CI = 1.03 to 2.31; and buttocks: P = 0.10, OR = 1.41 95% CI = 0.94 to 2.12]. We also saw borderline significance for haplogroup T as protective against lipoatrophy (P = 0.05, OR = 0.52, 95% CI = 0.20 to 1.00). These data suggest that mitochondrial DNA haplogroup may influence the propensity for lipoatrophy in patients receiving nucleoside reverse transcriptase inhibitors.
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Hendrickson SL, Hutcheson HB, Ruiz-Pesini E, Poole JC, Lautenberger J, Sezgin E, Kingsley L, Goedert JJ, Vlahov D, Donfield S, Wallace DC, O'Brien SJ. Mitochondrial DNA haplogroups influence AIDS progression. AIDS 2008; 22:2429-39. [PMID: 19005266 DOI: 10.1097/qad.0b013e32831940bb] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Mitochondrial function plays a role in both AIDS progression and HAART toxicity; therefore, we sought to determine whether mitochondrial DNA variation revealed novel AIDS restriction genes, particularly as mitochondrial DNA single-nucleotide polymorphisms are known to influence regulation of oxidative phosphorylation, reactive oxygen species production, and apoptosis. DESIGN This is a retrospective cohort study. METHODS We performed an association study of mitochondrial DNA haplogroups among 1833 European American HIV-1 patients from five US cohorts: the Multicenter AIDS Cohort Study, the San Francisco City Clinic Study, Hemophilia Growth and Development Study, the Multicenter Hemophilia Cohort Study, and the AIDS Linked to Intravenous Experiences cohort to determine whether the mitochondrial DNA haplogroup correlated with AIDS progression rate. RESULTS Mitochondrial DNA haplogroups J and U5a were elevated among HIV-1 infected people who display accelerated progression to AIDS and death. Haplogroups Uk, H3, and IWX appeared to be highly protective against AIDS progression. CONCLUSION The associations found in our study appear to support a functional explanation by which mitochondrial DNA variation among haplogroups, influencing ATP production, reactive oxygen species generation, and apoptosis, is correlated to AIDS disease progression; however, repeating these results in cohorts with different ethnic backgrounds would be informative. These data suggest that mitochondrial genes are important indicators of AIDS disease progression in HIV-1 infected persons.
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Lindegaard B, Hansen T, Hvid T, van Hall G, Plomgaard P, Ditlevsen S, Gerstoft J, Pedersen BK. The effect of strength and endurance training on insulin sensitivity and fat distribution in human immunodeficiency virus-infected patients with lipodystrophy. J Clin Endocrinol Metab 2008; 93:3860-9. [PMID: 18628529 DOI: 10.1210/jc.2007-2733] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
CONTEXT Fat redistribution, insulin resistance, and low-grade inflammation characterize HIV-infected patients with lipodystrophy. Currently, no effective therapies exist for the combined treatment of fat redistribution and insulin resistance. OBJECTIVE Our objective was to evaluate the effects of strength and endurance training on insulin sensitivity and fat distribution in HIV-infected patients with lipodystrophy. SUBJECTS AND METHODS Twenty sedentary HIV-infected men with lipodystrophy were randomly assigned to supervised strength or endurance training three times a week for 16 wk. The primary endpoints were improved peripheral insulin sensitivity (euglycemic-hyperinsulinemic clamp combined with isotope-tracer infusion) and body fat composition (dual-energy x-ray absorptiometry scan). Secondary endpoints included fasting lipids and inflammatory markers. RESULTS Insulin-mediated glucose uptake increased with both endurance training (55.7 +/- 11 to 63.0 +/- 11 micromol glucose/kg lean mass.min, P = 0.02) and strength training (49.0 +/- 12 to 57.8 +/- 18 micromol glucose/kg lean mass.min, P = 0.005), irrespective of training modality (P = 0.24). Only strength training increased total lean mass 2.1 kg [95% confidence interval (CI), 0.8-3.3], decreased total fat 3.3 kg (95% CI, -4.6 to -2.0), trunk fat 2.5 kg (95% CI, -3.5 to -1.5), and limb fat 0.75 kg (95% CI, -1.1 to -0.4). Strength training significantly decreased total and limb fat mass to a larger extent than endurance training (P < 0.05). Endurance training reduced total cholesterol, low-density lipoprotein cholesterol, free fatty acids, high-sensitivity C-reactive protein, IL-6, IL-18, and TNF-alpha and increased high-density lipoprotein cholesterol, whereas strength training decreased triglycerides, free fatty acids, and IL-18 and increased high-density lipoprotein cholesterol (P < 0.05 for all measurements). CONCLUSION This study demonstrates that both strength and endurance training improve peripheral insulin sensitivity, whereas only strength training reduces total body fat in HIV-infected patients with lipodystrophy.
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Affiliation(s)
- B Lindegaard
- Department of Infectious Diseases, Copenhagen Muscle Research Centre, DK-2100 Copenhagen, Denmark.
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14
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Effros RB, Fletcher CV, Gebo K, Halter JB, Hazzard WR, Horne FM, Huebner RE, Janoff EN, Justice AC, Kuritzkes D, Nayfield SG, Plaeger SF, Schmader KE, Ashworth JR, Campanelli C, Clayton CP, Rada B, Woolard NF, High KP. Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions. Clin Infect Dis 2008; 47:542-53. [PMID: 18627268 PMCID: PMC3130308 DOI: 10.1086/590150] [Citation(s) in RCA: 396] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. Similarities between aging and the courses of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome suggest that HIV infection compresses the aging process, perhaps accelerating comorbidities and frailty. In a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the HIV Medical Association, the National Institute on Aging, and the National Institute on Allergy and Infectious Diseases, researchers in infectious diseases, geriatrics, immunology, and gerontology met to review what is known about HIV infection and aging, to identify research gaps, and to suggest high priority topics for future research. Answers to the questions posed are likely to help prioritize and balance strategies to slow the progression of HIV infection, to address comorbidities and drug toxicity, and to enhance understanding about both HIV infection and aging.
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Affiliation(s)
- Rita B. Effros
- David Geffen School of Medicine at the University of California, Los Angeles
| | | | - Kelly Gebo
- Johns Hopkins University School of Medicine, Baltimore
| | | | | | | | - Robin E. Huebner
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Edward N. Janoff
- Mucosal and Vaccine Research Program Colorado, University of Colorado School of Medicine, Denver
| | | | - Daniel Kuritzkes
- Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Susan F. Plaeger
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | | | | | | | | | - Beth Rada
- Infectious Diseases Society of America, Arlington, Virginia
| | - Nancy F. Woolard
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Kevin P. High
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
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15
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Effros R, Fletcher C, Gebo K, Halter J, Hazzard W, Horne F, Huebner R, Janoff E, Justice A, Kuritzkes D, Nayfield S, Plaeger S, Schmader K, Ashworth J, Campanelli C, Clayton C, Rada B, Woolard N, High K. Aging and Infectious Diseases: Workshop on HIV Infection and Aging: What Is Known and Future Research Directions. Clin Infect Dis 2008. [DOI: https:/doi.10.1086/590150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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16
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Duong M, Dumas JP, Buisson M, Martha B, Piroth L, Grappin M, Waldner A, Chavanet P, Portier H. Limitation of exercise capacity in nucleoside-treated HIV-infected patients with hyperlactataemia. HIV Med 2007; 8:105-11. [PMID: 17352767 DOI: 10.1111/j.1468-1293.2007.00439.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inhibition of DNA polymerase gamma by nucleoside reverse transcriptase inhibitors (NRTIs) can cause mitochondrial dysfunction and cellular toxicity. Hyperlactataemia, which is a consequence of a shift in the metabolism of pyruvate, is an indicator of nucleoside-related mitochondrial toxicity. METHODS We evaluated exercise and oxidative capacities as well as circulatory and ventilatory responses to exercise in 24 HIV-infected patients on NRTIs presenting hyperlactataemia [mean (+/-standard deviation) fasted lactate=3.5+/-1.1 mmol/L]; 27 NRTI-treated patients with normal baseline lactate concentrations were used as controls (mean fasted lactate=1.6+/-0.3 mmol/L). RESULTS In the patients with hyperlactataemia, the average peak work capacity (1.7+/-0.6 W/kg) and peak oxygen consumption (VO(2)) (21+/-4 mL/kg/min) were significantly lower (P<0.01) than in control subjects (work, 2.1+/-0.4 W/kg; VO(2), 25+/-4 mL/kg/min). The capacity to increase oxygen extraction during exercise was significantly diminished in the hyperlactataemia group, as shown by a low peak systemic arteriovenous oxygen difference (a-vO(2)) difference compared with controls (11+/-3 vs 14+/-3 mL/dL; P=0.008), and as indicated by a linear correlation between VO(2) and systemic a-vO(2) difference (r(2)=0.76). During exercise, the increases in cardiac output relative to VO(2) (mean Delta cardiac output (Q)/DeltaVO(2)=8+/-3.6) and ventilation (mean Delta ventilation (VE)/DeltaVO(2)=48.6+/-13.2) were significantly higher in hyperlactataemia patients compared with controls (mean cardiac output Delta(Q)/DeltaVO(2)=6+/-2; mean DeltaVE/DeltaVO(2)=42+/-12.7; P=0.03). CONCLUSIONS The degree of exercise limitation in patients with nucleoside-related mitochondrial toxicity correlates directly with the severity of impaired muscle oxidative phosphorylation, as indicated by the capacity for muscle oxygen extraction. Exaggerated circulatory and ventilatory responses to exercise are direct consequences of the level of impaired muscle oxidative phosphorylation.
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Affiliation(s)
- M Duong
- Service des Maladies Infectieuses, Hôpital Universitaire du Bocage, Dijon, France.
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17
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Scatena R, Bottoni P, Botta G, Martorana GE, Giardina B. The role of mitochondria in pharmacotoxicology: a reevaluation of an old, newly emerging topic. Am J Physiol Cell Physiol 2007; 293:C12-21. [PMID: 17475665 DOI: 10.1152/ajpcell.00314.2006] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In addition to their well-known critical role in energy metabolism, mitochondria are now recognized as the location where various catabolic and anabolic processes, calcium fluxes, various oxygen-nitrogen reactive species, and other signal transduction pathways interact to maintain cell homeostasis and to mediate cellular responses to different stimuli. It is important to consider how pharmacological agents affect mitochondrial biochemistry, not only because of toxicological concerns but also because of potential therapeutic applications. Several potential targets could be envisaged at the mitochondrial level that may underlie the toxic effects of some drugs. Recently, antiviral nucleoside analogs have displayed mitochondrial toxicity through the inhibition of DNA polymerase-γ (pol-γ). Other drugs that target different components of mitochondrial channels can disrupt ion homeostasis or interfere with the mitochondrial permeability transition pore. Many known inhibitors of the mitochondrial electron transfer chain act by interfering with one or more of the respiratory chain complexes. Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, may behave as oxidative phosphorylation uncouplers. The mitochondrial toxicity of other drugs seems to depend on free radical production, although the mechanisms have not yet been clarified. Meanwhile, drugs targeting mitochondria have been used to treat mitochondrial dysfunctions. Importantly, drugs that target the mitochondria of cancer cells have been developed recently; such drugs can trigger apoptosis or necrosis of the cancer cells. Thus the aim of this review is to highlight the role of mitochondria in pharmacotoxicology, and to describe whenever possible the main molecular mechanisms underlying unwanted and/or therapeutic effects.
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Affiliation(s)
- Roberto Scatena
- Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy.
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18
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Sutinen J, Yki-Järvinen H. Increased resting energy expenditure, fat oxidation, and food intake in patients with highly active antiretroviral therapy-associated lipodystrophy. Am J Physiol Endocrinol Metab 2007; 292:E687-92. [PMID: 17062843 DOI: 10.1152/ajpendo.00219.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Highly active antiretroviral therapy (HAART) is associated with metabolic adverse events such as lipodystrophy in human immunodeficiency virus (HIV)-infected patients. The objective of the present study was to evaluate the effects of HAART-associated lipodystrophy on resting energy expenditure and caloric intake. In this cross-sectional study we compared resting energy expenditure (REE) and energy intake in 30 HAART-treated patients with lipodystrophy (HAART+LD+) with 13 HAART-treated patients without lipodystrophy (HAART+LD-). REE was measured using indirect calorimetry, and energy intake was recorded as a 3-day diary of food intake. REE (5,180+/-160 vs. 4,260+/-150 J/min, P<0.01) and also REE expressed per fat-free mass (86+/-1 vs. 78+/-2 J.kg fat-free mass-1.min-1, P<0.01) were significantly higher in the HAART+LD+ than the HAART+LD- group. Rate of lipid oxidation was significantly higher in the HAART+LD+ than the HAART+LD- group. Total energy and fat intakes were significantly increased in the HAART+LD+ compared with the HAART+LD- group. These results imply that HAART-associated lipodystrophy is associated with increased REE and lipid oxidation and with increased caloric and fat intake.
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Affiliation(s)
- Jussi Sutinen
- Department of Medicine, Helsinki University Central Hospital, PO Box 348, FIN-00029 HUS, Helsinki, Finland.
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19
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Oursler KK, Sorkin JD, Smith BA, Katzel LI. Reduced aerobic capacity and physical functioning in older HIV-infected men. AIDS Res Hum Retroviruses 2006; 22:1113-21. [PMID: 17147498 DOI: 10.1089/aid.2006.22.1113] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aerobic capacity and physical functioning decline with age and chronic illness. The extent of physical disability is unknown in older HIV-infected adults, who represent a rapidly growing proportion of HIV/AIDS patients in the United States. We performed functional performance testing including treadmill testing in 32 HIV-infected male veterans aged 40-69 years. Controls were 47 healthy male subjects tested previously in the same exercise laboratory. HIV-infected subjects were classified as younger (40-49 years, n = 12) or older age (50+ years, n = 20). Peak aerobic capacity (VO2peak) was significantly reduced in the older vs. younger HIV subjects [19.1 mL/kg/min +/- 5.7 (mean, SD) vs. 25.2 +/- 4.2, p = 0.01]. VO2peak was reduced 41% +/- 15% (mean, SD) in HIV-infected subjects compared to expected values from age-matched healthy controls. Regression analyses show a similar decline in VO2peak with age in HIV-infected and healthy controls. Mean 6-min walk distance was not significantly different between the HIV-infected age groups, and was reduced only 8% compared to expected values for healthy adults. Current CD4 count and HAART exposure were similar in the two age groups and were not significantly associated with VO2peak. Anemia (HCT <35%) was significantly associated with reduced VO2peak (p = 0.02), but this association was not independent of the effect of age (p = 0.1). We conclude that older HIV-infected adults have markedly impaired aerobic capacity but maintain the capacity to undertake day-to-day activities. Additional physiologic and metabolic testing is needed to measure the effect of HAART toxicity and primary aging on aerobic capacity, and to determine if older HIV-infected adults are at greater risk.
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Affiliation(s)
- K K Oursler
- University of Maryland School of Medicine, and the Baltimore Veterans Administration Medical Center, Geriatric Research, Education and Clinical Center, Baltimore, Maryland 21201, USA.
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20
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Lo JC, Kazemi MR, Hsue PY, Martin JN, Deeks SG, Schambelan M, Mulligan K. The Relationship between Nucleoside Analogue Treatment Duration, Insulin Resistance, and Fasting Arterialized Lactate Level in Patients with HIV Infection. Clin Infect Dis 2005; 41:1335-40. [PMID: 16206112 DOI: 10.1086/496981] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2005] [Accepted: 06/14/2005] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Treatment with nucleoside reverse-transcriptase inhibitors (NRTIs) is associated with hyperlactatemia, presumably as a result of NRTI-induced mitochondrial toxicity. We examined the association of NRTI treatment duration and lactate level in human immunodeficiency virus (HIV)-infected patients and assessed the relationship of treatment duration and lactate level with insulin resistance. METHODS Fasting arterialized venous lactate levels, routine blood chemistry findings, insulin resistance (determined by homeostasis model assessment [HOMA-IR]), percentage of body fat (determined by dual-energy radiographic absorptiometry), and detailed histories of antiretroviral therapy were obtained for 95 HIV-infected individuals. The independent association of NRTI treatment duration and lactate level was examined using multivariable linear regression. RESULTS Among 95 subjects with a mean age (+/- standard deviation [SD]) of 44 +/- 8 years), 95% had NRTI exposure, with current NRTI use in 83%. The mean (+/- SD) lactate level was 1.24 +/- 0.46 mmol/L (6% had a lactate level > 2 mmol/L). Longer duration of NRTI use was positively associated with lactate level (beta = 0.047; P < .01), as were age, duration of protease inhibitor treatment, and HOMA-IR. Female sex and percentage of body fat were negatively associated with lactate level. After adjustment for age, sex, diabetes, percentage of body fat, and duration of protease inhibitor therapy, an increased duration of NRTI therapy remained significantly associated with lactate level (beta = 0.035; P = .04). However, the addition of HOMA-IR to the adjusted model attenuated the relation between duration of NRTI therapy and lactate level (beta = 0.024; P = .14), whereas HOMA-IR was significantly associated with lactate level (beta = 0.206; P < .01). Furthermore, HOMA-IR was also associated with NRTI treatment duration in adjusted analyses. CONCLUSION NRTI treatment duration was independently associated with higher lactate level, but this relationship was attenuated after adjusting for HOMA-IR. These data raise the possibility that insulin resistance may be an additional mechanism through which NRTI therapy is related to lactate level.
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Affiliation(s)
- Joan C Lo
- Department of Medicine, University of California San Francisco, CA, USA.
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21
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Ghosn J, Guiguet M, Jardel C, Benyaou R, Zeller V, Simon A, Valantin MA, Amellal B, Assoumo L, Hogrel JY, Costagliola D, Katlama C, Lombès A. Muscle and Liver Lactate Metabolism in Haart-Treated and Naive HIV-Infected Patients: The Mitovir Study. Antivir Ther 2005. [DOI: 10.1177/135965350501000412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To assess the impact of nucleoside analogue reverse transcriptase inhibitor (NRTI) combination therapy on muscle and liver lactate metabolism in HIV-infected patients. Methods This cross-sectional study involved HIV-infected patients who were either antiretroviral-naive (Group 1) or were receiving either a stable triple-drug combination including at least one d-drug (zidovudine, zalcitabine, stavudine, didanosine; Group 2) or a backbone of abacavir and lamivudine (Group 3). Lactataemia was measured at rest. Muscle lactate metabolism was assessed during a standardized exercise test and liver lactate metabolism during intravenous lactate infusion. Mitochondrial DNA was quantified in peripheral blood mononuclear cells. Results A total of 65 patients were enrolled (16, 31 and 18 patients in Group 1, Group 2 and Group 3, respectively). None of the patients had symptoms of hyperlactataemia. Patients in Group 3 had received d-drugs for a median of seven years before switching to abacavir and lamivudine. Median baseline lactataemia, although within the normal range, was significantly higher in both treatment groups than in the naive patients (Group 2: 1.4, Group 3: 1.5, and Group 1: 1.0 mmol/l, P=0.005). Muscle lactate clearance was significantly lower in both treatment groups than in naive patients (Group 2: 1.6, Group 3: 1.8, and Group 1: 2.1, P=0.01). Lactate liver metabolism and mitochondrial DNA levels did not differ among the three groups. Conclusions In HIV-infected patients without symptomatic hyperlactataemia, all NRTI-containing HAART regimens appear to cause muscle mitochondrial damage but to spare the liver. Absence of difference between Group 2 and Group 3 raises questions about the potential reversibility of muscle mitochondrial dysfunction, and/or the ability of abacavir and lamivudine to induce such mitochondrial damage.
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Affiliation(s)
- Jade Ghosn
- Département des Maladies Infectieuses, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Marguerite Guiguet
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Claude Jardel
- Laboratoire de Biochimie, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
- Institut de Myologie, INSERM 582, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Rabah Benyaou
- Institut de Myologie, INSERM 582, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Valérie Zeller
- Département des Maladies Infectieuses, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Anne Simon
- Service de Médecine Interne, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Marc-Antoine Valantin
- Département des Maladies Infectieuses, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Bahia Amellal
- Laboratoire de Virologie, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Lambert Assoumo
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Jean-Yves Hogrel
- Institut de Myologie, INSERM 582, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Dominique Costagliola
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Christine Katlama
- Département des Maladies Infectieuses, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
- INSERM U720, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Anne Lombès
- Institut de Myologie, INSERM 582, CHU Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France
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Casademont J, Sanjurjo E, Garrabou G, Miró Ò. Diagnosis of Mitochondrial Dysfunction in HIV-Infected Patients under Highly Active Antiretroviral Therapy: Possibilities beyond the Standard Procedures. Antivir Ther 2005. [DOI: 10.1177/135965350501002s07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jordi Casademont
- Laboratory of Mitochondrial Function, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Medical School, University of Barcelona, Barcelona, Catalonia, Spain
| | - Eduard Sanjurjo
- Laboratory of Mitochondrial Function, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Medical School, University of Barcelona, Barcelona, Catalonia, Spain
| | - Gloria Garrabou
- Laboratory of Mitochondrial Function, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Medical School, University of Barcelona, Barcelona, Catalonia, Spain
| | - Òscar Miró
- Laboratory of Mitochondrial Function, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Medical School, University of Barcelona, Barcelona, Catalonia, Spain
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23
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Miró Ò, López S, Cardellach F, Casademont J. Mitochondrial Studies in Haart-Related Lipodystrophy: From Experimental Hypothesis to Clinical Findings. Antivir Ther 2005. [DOI: 10.1177/135965350501002s08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic use of antiretrovirals (ARVs) to treat HIV infection, along with more prolonged patient survival, has been associated with an increase in adverse drug effects in HIV-infected patients on treatment. It has been proposed that some of these adverse effects (including myopathy, cardiomyopathy, anaemia, hyperlactataemia/ lactic acidosis, pancreatitis, polyneuritis and lipodystrophy) could be mediated by mitochondrial (mt) toxicity. From the experimental data, it has been proposed that nucleoside analogue reverse transcriptase inhibitors (NRTIs) also inhibit γ-polymerase, the enzyme devoted to replicate (and, to a lesser extent, repair) mtDNA. It is now widely accepted that the use of most NRTIs in HIV-infected patients is associated with mtDNA depletion. Although cross-sectional studies suggest that certain ARVs, especially stavudine, are more toxic to mitochondria, the differences among different highly active ARV therapy (HAART) schedules detected in the analysis of longitudinal studies are not so clear. These types of study in previously untreated individuals suggest that the greatest mtDNA loss appears at the beginning of the treatment. Conversely, in ARV-experienced patients, the potential beneficial effects of HAART changes in terms of mtDNA content remain controversial and must be further investigated. Functional studies accompanying genetic investigations are needed for the correct pathogenic interpretation of the mtDNA abnormalities.
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Affiliation(s)
- Òscar Miró
- Mitochondrial Research Laboratory, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | - Sònia López
- Mitochondrial Research Laboratory, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | - Francesc Cardellach
- Mitochondrial Research Laboratory, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | - Jordi Casademont
- Mitochondrial Research Laboratory, Department of Internal Medicine, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
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