Skeletal myopathy associated with nucleoside reverse transcriptase inhibitor therapy: potential benefit of coenzyme Q10 therapy.
Zidovudine (ZDV) has been associated with 'ragged-red' fibre myopathy, due to its effects on myocyte mitochondria. Usually this is reversible with cessation of ZDV. We report a 52-year-old man, who in 1985 developed ragged-red fibre myopathy 14 years after diagnosis of HIV infection while on effective ZDV-based combination antiretroviral therapy (ART). He was treated with the mitochondrial anti-oxidant coenzyme Q10 and made an excellent recovery, without change of ARTs. This suggests a novel therapy for further investigation targeted at ZDV induced myopathy, potentially allowing continuation of antiviral treatments including ZDV.
Rosenfeldt
Franklin L
FL
Cardiac Surgical Research Unit, Alfred Hospital & Baker Heart Research Institute, Department of Surgery, Monash University, Parkville, Australia. f.rosenfeldt@alfred.org.au
Mijch
Anne
A
McCrystal
Graham
G
Sweeney
Clare
C
Pepe
Salvatore
S
Nicholls
Melissa
M
Dennett
Xenia
X
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D003067:Coenzymes; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000473:pathology; D009135:Muscular Diseases / Q000209:etiology*; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000378:metabolism / Q000627:therapeutic use; D015215:Zidovudine / Q000009:adverse effects* / Q000627:therapeutic use
D003067:Coenzymes; D018894:Reverse Transcriptase Inhibitors; D014451:Ubiquinone; D015215:Zidovudine; C024989:coenzyme Q10