N Engl J Med.
Mitochondria are essential for oxidative phosphorylation.
Because NRTIs deplete mitochondrial DNA, their clinical effects can include myopathy, cardiomyopathy, neuropathy, lactic acidosis, and exocrine pancreatic, liver, and bone-marrow failure. Toxicities usually reversed with drug discontinuation but persisted in some. In 1999, French researchers reported deaths of 2 HIV-uninfected infants at 1 year of age as a result of severe progressive neurologic symptoms related to mitochondrial dysfunction. Review of living uninfected children with antiretroviral exposure is ongoing. The objective was to determine whether perinatal zidovudine exposure had acute or chronic effects on left ventricular structure or function, including mean left ventricular fractional shortening, end-diastolic dimension, contractility, or mass.