Although much more research is needed to fully understand this issue, this article explores the current thoughts about the connections among mitochondrial toxicity, lactic acidosis and lipodystrophy.
Mitochondria are tiny rods found inside all human cells.
In the past, lactic acidosis syndrome was described as a very rare side effect of these medications leading to death in more than half of the cases despite aggressive medical care. This milder form is treatable and reversible if recognized early and if the offending medication is stopped. While it is unclear where the pathology is in this syndrome, some investigators feel that the dysfunction may be related to pathology in the liver. Being female and being over-weight are felt to be risk factors for developing this syndrome. Lactic acidosis syndrome and hyperlactatemia are felt to be caused by the toxic effect of NRTIs on mitochondrial function.