Record Details

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; Department of Neurology, Grey’s Hospital, Pietermaritzburg and University of KwaZulu-Natal, Durban, South Africa Bhola, Sudika; Department of Neurology, Grey’s Hospital, Pietermaritzburg and University of KwaZulu-Natal, Durban, South Africa Omar, Fierdoz; Chemical Pathology Laboratory, Groote Schuur Hospital; National Health Laboratory Service and University of Cape Town, South Africa Mogambery, Jade; Department of Medicine, Grey’s Hospital, Pietermaritzburg, South Africa
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.14484T>C and m.11778G>A) 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 Publishing
Date 2014-05-23
Format application/pdf
Identifier 10.4102/hivmed.v15i2.24
Source Southern African Journal of HIV Medicine; Vol 15, No 2 (2014); 69-71
Language en
Coverage South Africa 2012 to 2014
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