Mitochondrial Toxicity and Lipodystrophy

  • Grace McComsey
Part of the Infectious Disease book series (ID)


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, 6, 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.


Mitochondrial Toxicity Meta Boli Lactic Acidemia Venous Lactate Level Symptomatic Hyperlactatemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Grace McComsey
    • 1
  1. 1.Case Western Reserve UniversityCleveland

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