Effect of the substitution of one nucleoside analogue by one non-nucleoside reverse transcriptase inhibitor over mitochondrial DNA levels.

BACKGROUND

Long-term antiretroviral therapy is associated with several side effects, like mitochondrial toxicity related to nucleoside reverse transcriptase inhibitors (NRTIs). Our objective was to analyze the effect of the substitution of one NRTI by one non-nucleoside reverse transcriptase inhibitor (NNRTI) in the antiretroviral regime of HIV-1-infected patients who were on a regime containing either two NRTIs and one NNRTI, or one NRTI, one NNRTI and one protease inhibitor (PI), over mtDNA level. Decreasing NRTIs could increase mtDNA level.

METHODS

Fifteen HIV-1-infected patients were included in the study. As controls, 17 healthy individuals and 15 HIV-1-infected patients naïve for antiretroviral treatment were also analyzed. mtDNA level was quantified at baseline and after 48 weeks of treatment.

RESULTS

Control groups showed higher levels of mtDNA than the study group (p<0.001). Among this latter group, no statistical differences between baseline and after 48 weeks were found. Naïve HIV-infected patients had lower mtDNA than healthy volunteers (p<0.001). Two patients had two consecutive blips (low viral load increases) but they did not show NNRTI-related resistance mutations.

CONCLUSIONS

This study shows that although this treatment was immunovirologically effective, mtDNA level did not increase at least after 48 weeks.