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In Vivo Mitochondrial Function in HIV-Infected Persons Treated with Contemporary Anti-Retroviral Therapy: A Magnetic Resonance Spectroscopy Study

Lookup NU author(s): Dr Brendan PayneORCiD, Dr Kieren Hollingsworth, David Ashley Price, Professor Mike TrenellORCiD, Professor Patrick Chinnery



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Modern anti-retroviral therapy is highly effective at suppressing viral replication and restoring immune function in HIV-infected persons. However, such individuals show reduced physiological performance and increased frailty compared with age-matched uninfected persons. Contemporary anti-retroviral therapy is thought to be largely free from neuromuscular complications, whereas several anti-retroviral drugs previously in common usage have been associated with mitochondrial toxicity. It has recently been established that patients with prior exposure to such drugs exhibit irreversible cellular and molecular mitochondrial defects. However the functional significance of such damage remains unknown. Here we use phosphorus magnetic resonance spectroscopy (P-31-MRS) to measure in vivo muscle mitochondrial oxidative function, in patients treated with contemporary anti-retroviral therapy, and compare with biopsy findings (cytochrome c oxidase (COX) histochemistry). We show that dynamic oxidative function (post-exertional ATP (adenosine triphosphate) resynthesis) was largely maintained in the face of mild to moderate COX defects (affecting up to similar to 10% of fibers): iota(1/2) ADP (half-life of adenosine diphosphate clearance), HIV-infected 22.1 +/- 9.9 s, HIV-uninfected 18.8 +/- 4.4 s, p = 0.09. In contrast, HIV-infected patients had a significant derangement of resting state ATP metabolism compared with controls: ADP/ATP ratio, HIV-infected 1.24 +/- 0.08x10(-3), HIV-uninfected 1.16 +/- 0.05x10(-3), p = 0.001. These observations are broadly reassuring in that they suggest that in vivo mitochondrial function in patients on contemporary anti-retroviral therapy is largely maintained at the whole organ level, despite histochemical (COX) defects within individual cells. Basal energy requirements may nevertheless be increased.

Publication metadata

Author(s): Payne BAI, Hollingsworth KG, Baxter J, Wilkins E, Lee V, Price DA, Trenell M, Chinnery PF

Publication type: Article

Publication status: Published

Journal: PLoS One

Year: 2014

Volume: 9

Issue: 1

Print publication date: 07/01/2014

Acceptance date: 18/11/2013

Date deposited: 28/03/2014

ISSN (electronic): 1932-6203

Publisher: Public Library of Science


DOI: 10.1371/journal.pone.0084678


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Funder referenceFunder name
Newcastle National Institute for Health Research (NIHR) Biomedical Research Centre in Ageing and Age-Related Diseases
Medical Research Council (MRC, UK) Centre for Translational Muscle Disease
084980/Z/08/ZWellcome Trust
096919Z/11/ZWellcome Trust
G1100160Medical Research Council (MRC, UK)