Antiretroviral therapy-induced Leber’s hereditary optic neuropathy

Southern African Journal of HIV Medicine

Field Value
Title Antiretroviral therapy-induced Leber’s hereditary optic neuropathy
Creator Moodley, Anand Bhola, Sudika Omar, Fierdoz Mogambery, Jade
Subject Infectious disease; Neurology; Neuro-ophthalmology; Ophthalmology Leber's hereditary optic neuropathy; LHON; Nucleoside reverse transcriptase inhibitor; antiretrovirals; mitochondrial disease Neuro-ophthalmology
Description Optic neuropathy in HIV-infected patients results from the HIV infection itself, post-infectious auto-immune disease, opportunistic infections and drugs. Nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine and stavudine have known mitochondrial toxicity and can cause mitochondrial myopathies, neuropathies, hyperlactataemia, and can induce mitochondrial genetic disorders. Individuals with the mutation for Leber’s hereditary optic neuropathy (LHON), a mitochondrial disorder, are usually asymptomatic but develop visual loss when exposed to external triggers such as smoking. We report on two HIV-infected patients with LHON mutations (m.14484TC and m.11778GA) who developed profound visual loss with antiretroviral therapy. We postulate that the phenotypic expression of LHON in these genetically predisposed individuals was triggered by NRTI drugs lamivudine and tenofovir when used in combination, despite their relatively weak mitochondrial toxic effects. 
Publisher AOSIS
Date 2014-05-23
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion —
Format application/pdf
Identifier 10.4102/sajhivmed.v15i2.24
Source Southern African Journal of HIV Medicine; Vol 15, No 2 (2014); 69-71 2078-6751 1608-9693
Language eng
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Coverage South Africa 2012 to 2014
Rights Copyright (c) 2014 Anand Moodley, Sudika Bhola, Fierdoz Omar, Jade Mogambery