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Mitochondrial Toxicity and Lipodystrophy

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Book cover Reverse Transcriptase Inhibitors in HIV/AIDS Therapy

Part of the book series: Infectious Disease ((ID))

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Abstract

The advent of potent antiretroviral drugs (ARV) in recent years has had an impressive impact on mortality and disease progression in HIV-infected patients (1 , therefore, issues related to long-term effects of ARV are of growing importance. Perhaps the most serious and distressing toxicities are mitochondrial toxicity and lipodystrophy, a syndrome of fat redistribution recently linked to mitochondrial dysfunction. Lipodystrophy includes peripheral fat wasting (referred to as lipoatrophy), with or without fat accumulation (abdominal visceral fat accumulation, breast enlargement, and/or buffalo hump). It is commonly associated with metabolic abnormalities—dyslipidemias and/or insulin resistance (2, 3). The lipodystrophy syndrome was initially believed to be associated with use of protease inhibitor (PI) agents (3, 4), but recent studies called into question this association (5–7). Lipodystrophy is not only disfiguring, but is also associated with decreased adherence to ARV (8), hypertension (9), as well as decreased quality of life, self-esteem, and sexual difficulties (10). The lipodystrophy syndrome will be discussed here, mainly as it relates to nucleoside reverse transcriptase inhibitor (NRTI) therapy and mitochondrial toxicity.

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Authors and Affiliations

  1. Case Western Reserve University, Cleveland, OH

    Grace McComsey (Chief, Pediatric Infectious Diseases and Rheumatology; Associate Professor of Pediatrics and Medicine)

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  1. Grace McComsey
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Editors and Affiliations

  1. National Institute of Allergy and Infectious Diseases National Institutes of Health, USA

    Vassil St.Georgiev

  2. Division of Infectious Diseases, Roger Williams Medical Center, Providence, RI

    Gail Skowron MD (Chief) (Chief)

  3. Boston University School of Medicine, Boston, MA

    Gail Skowron MD (Chief) (Chief)

  4. Pfizer Inc., San Diego, CA

    Richard Ogden PhD

  5. Center for Poverty-Related Communicable Diseases Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Joep M. A. Lange MD, PhD (Professor of Medicine) (Professor of Medicine)

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© 2006 Humana Press Inc., Totowa, NJ

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McComsey, G. (2006). Mitochondrial Toxicity and Lipodystrophy. In: St.Georgiev, V., Skowron, G., Ogden, R., Lange, J.M.A. (eds) Reverse Transcriptase Inhibitors in HIV/AIDS Therapy. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-59745-085-0_10

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  • DOI: https://doi.org/10.1007/978-1-59745-085-0_10

  • Publisher Name: Humana Press

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  • Online ISBN: 978-1-59745-085-0

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