title: Successful Treatment of Mitochondrial Toxicity in an HIV-Positive Patient After Liver Transplantation.
abstract: Liver transplantation in patients infected with the human immunodeficiency virus (HIV) has been increasingly performed with reasonable outcomes; however, medical management of both immunosuppression and antiretroviral therapy can be challenging owing to drug toxicities and interactions. Nucleoside reverse transcriptase inhibitors (NRTIs), a common backbone of highly active antiretroviral therapy (HAART), were the first class of effective antiretroviral drugs developed. NRTIs are commonly used for posttransplant HAART therapy and have a rare but fatal complication of mitochondrial toxicity, manifesting as severe lactic acidosis, hepatic steatosis, and lipoatrophy. Herein, we have reported on the first known successful treatment of severe mitochondrial toxicity secondary to NRTIs in an HIV-infected transplant recipient.
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California. Electronic address: Irene.Kim@cshs.org.
authors.forename: I K
authors.initials: IK
authors.lastname: Kim
authors.affiliation: Department of Infectious Disease, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: C
authors.initials: C
authors.lastname: Gaultier
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: J
authors.initials: J
authors.lastname: Steggerda
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: S-H
authors.initials: SH
authors.lastname: Pan
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: A S
authors.initials: AS
authors.lastname: Klein
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: A
authors.initials: A
authors.lastname: Annamalai
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: T
authors.initials: T
authors.lastname: Tran
authors.affiliation: Comprehensive Transplant Center, Los Angeles, California.
authors.forename: N N
authors.initials: NN
authors.lastname: Nissen
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000628:therapy*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000187:drug effects*; D028361:Mitochondrial Diseases / Q000139:chemically induced / Q000628:therapy*; D019562:Viral Load