Mitochondrial toxicity is associated with virological response in patients with HIV and hepatitis C virus coinfection treated with ribavirin and highly active antiretroviral therapy.

The combination of highly active antiretroviral therapy (HAART) plus ribavirin (RBV) in patients with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection has been reported to cause mitochondrial toxicity (MT). Sixty-four patients with HIV-HCV coinfection who were receiving antiviral therapy were evaluated for MT. Patients with concomitant HAART showed greater increases in lactate levels than did patients without HAART, and this difference was more pronounced in patients who received higher dosages of RBV. The incidence of pancreatic enzyme elevations and symptomatic pancreatitis was higher among patients who received HAART and high-dose RBV. Hepatic steatosis increased in patients who received HAART and high-dose RBV. Patients who showed signs of MT achieved higher rates of sustained virologic response than did patients without MT (73% vs 44%).

[1]  A. Rieger,et al.  HIV–HCV co‐infected patients with low CD4+ cell nadirs are at risk for faster fibrosis progression and portal hypertension , 2009, Journal of viral hepatitis.

[2]  F. Carrat,et al.  Risk factors for anaemia in human immunodeficiency virus/hepatitis C virus‐coinfected patients treated with interferon plus ribavirin , 2007, Journal of viral hepatitis.

[3]  V. Soriano,et al.  Care of patients coinfected with HIV and hepatitis C virus: 2007 updated recommendations from the HCV-HIV International Panel. , 2007, AIDS.

[4]  W. Lewis,et al.  A brief overview of mechanisms of mitochondrial toxicity from NRTIs , 2007, Environmental and molecular mutagenesis.

[5]  A. Perelson,et al.  The metabolism, pharmacokinetics and mechanisms of antiviral activity of ribavirin against hepatitis C virus , 2006, Cellular and Molecular Life Sciences CMLS.

[6]  U. Walker,et al.  Increased long-term mitochondrial toxicity in combinations of nucleoside analogue reverse-transcriptase inhibitors , 2002, AIDS.

[7]  T. Cihlar,et al.  Assessment of Mitochondrial Toxicity in Human Cells Treated with Tenofovir: Comparison with Other Nucleoside Reverse Transcriptase Inhibitors , 2002, Antimicrobial Agents and Chemotherapy.

[8]  F C Luft,et al.  Lactic acidosis update for critical care clinicians. , 2001, Journal of the American Society of Nephrology : JASN.

[9]  A. Lafeuillade,et al.  Increased mitochondrial toxicity with ribavirin in HIV/HCV coinfection , 2001, The Lancet.

[10]  G. Moyle.  Clinical manifestations and management of antiretroviral nucleoside analog-related mitochondrial toxicity. , 2000, Clinical therapeutics.

[11]  K. Abid,et al.  Hepatocyte steatosis is a cytopathic effect of hepatitis C virus genotype 3. , 2000, Journal of hepatology.

[12]  C. Katlama,et al.  Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients , 1999, Hepatology.

[13]  M. Dalakas,et al.  Mitochondrial toxicity of antiviral drugs , 1995, Nature Medicine.