Langs-Barlow Allison, Renner Lorna, Katz Karol, Northrup Veronika, Paintsil Elijah
Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA.
AIDS Res Treat. 2013;2013:249171. doi: 10.1155/2013/249171. Epub 2013 Mar 7.
Mitochondrial damage is implicated in highly active antiretroviral therapy (HAART) toxicity. HIV infection also causes mitochondrial toxicity (MT). Differentiating between the two is critical for HIV management. Our objective was to test the utility of the Mitochondrial Disease Criteria (MDC) and the Enquête Périnatale Française (EPF) to screen for possible HAART related MT in HIV-infected children in Ghana. The EPF and MDC are compilations of clinical symptoms, or criteria, of MT: a (+) score indicates possible MT. We applied these criteria retrospectively to 403 charts of HIV-infected children. Of those studied, 331/403 received HAART. Comparing HAART exposed and HAART naïve children, the difference in EPF score, but not MDC, approached significance (P = 0.1). Young age at HIV diagnosis or at HAART initiation was associated with (+) EPF (P ≤ 0.01). Adherence to HAART trended toward an association with (+) EPF (P = 0.09). Exposure to nevirapine, abacavir, or didanosine increased risk of (+) EPF (OR = 3.55 (CI = 1.99-6.33), 4.76 (2.39-9.43), 4.93 (1.29-18.87)). Neither EPF nor MDC identified a significant difference between HAART exposed or naïve children regarding possible MT. However, as indicators of HAART exposure are associated with (+) EPF, it may be a candidate for prospective study of possible HAART related MT in resource-poor settings.
线粒体损伤与高效抗逆转录病毒治疗（HAART）毒性有关。HIV感染也会导致线粒体毒性（MT）。区分这两者对于HIV的管理至关重要。我们的目标是测试线粒体疾病标准（MDC）和法国围产期调查（EPF）在筛查加纳HIV感染儿童中可能与HAART相关的MT方面的效用。EPF和MDC是MT临床症状或标准的汇总：阳性评分表明可能存在MT。我们对403例HIV感染儿童的病历进行了回顾性应用这些标准。在这些研究对象中，331/403接受了HAART。比较接受HAART和未接受HAART的儿童，EPF评分存在差异，但MDC评分无差异，差异接近显著水平（P = 0.1）。HIV诊断或开始HAART时年龄较小与EPF阳性相关（P≤0.01）。坚持HAART与EPF阳性呈趋势性相关（P = 0.09）。接触奈韦拉平、阿巴卡韦或去羟肌苷会增加EPF阳性的风险（OR = 3.55（CI = 1.99 - 6.33），4.76（2.39 - 9.43），4.93（1.29 - 18.87））。EPF和MDC均未发现接受HAART或未接受HAART的儿童在可能的MT方面存在显著差异。然而，由于HAART暴露指标与EPF阳性相关，它可能是在资源匮乏地区对可能与HAART相关的MT进行前瞻性研究的一个候选指标。
