Mitochondrial damage is implicated in highly active antiretroviral therapy (HAART) toxicity. HIV infection also causes\r\nmitochondrial toxicity (MT). Differentiating between the two is critical for HIV management. Our objective was to test the utility\r\nof the Mitochondrial Disease Criteria (MDC) and the EnquÃ?â? ete PÃ?´erinatale FrancÃ?¸aise (EPF) to screen for possible HAART related\r\nMT in HIV-infected children in Ghana. The EPF and MDC are compilations of clinical symptoms, or criteria, of MT: a (+) score\r\nindicates possible MT. We applied these criteria retrospectively to 403 charts of HIV-infected children. Of those studied, 331/403\r\nreceived HAART. ComparingHAART exposed and HAART naÃ?¨ive children, the difference in EPF score, but notMDC, approached\r\nsignificance (P = 0.1). Young age at HIV diagnosis or at HAART initiation was associated with (+) EPF (P = 0.01). Adherence to\r\nHAART trended toward an association with (+) EPF (P = 0.09). Exposure to nevirapine, abacavir, or didanosine increased risk of\r\n(+) EPF (OR = 3.55 (CI = 1.99ââ?¬â??6.33), 4.76 (2.39ââ?¬â??9.43), 4.93 (1.29ââ?¬â??18.87)). Neither EPF nor MDC identified a significant difference\r\nbetween HAART exposed or naÃ?¨ive children regarding possible MT. However, as indicators of HAART exposure are associated with\r\n(+) EPF, it may be a candidate for prospective study of possible HAART related MT in resource-poor settings.
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