Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Nucleoside analogues and mitochondrial toxicity.

Russell Fleischer1, Debra Boxwell, Kenneth E Sherman

  • 1Division of Antiviral Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, Maryland 20857, USA. fleischerr@cder.fda.gov

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 20, 2004
PubMed
Summary

Patients with HIV and hepatitis C coinfection treated with ribavirin and didanosine experienced increased mitochondrial toxicity. This drug combination, including stavudine, led to severe events like liver failure and lactic acidosis, prompting label warnings.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Single cell RNA transcriptome response to fentanyl use in persons with HIV infection.

Scientific reports·2026
Same author

Brief Report: Hepatitis B Vaccination Histories in Persons With HIV Needing Revaccination.

Journal of acquired immune deficiency syndromes (1999)·2025
Same author

The Role of Liver Biopsy and Fine Needle Aspiration in Novel HBV Therapeutics in HIV and HBV Coinfection.

Current HIV/AIDS reports·2025
Same author

HepB-CpG Vaccine in People With HIV and Prior Nonresponse to HBV Vaccine: The BEe-HIVe Trial End-of-Study Results.

JAMA·2025
Same author

An efficient vaccine clinical trial: ACTG A5379 hepatitis B vaccine trial in persons with HIV.

Vaccine·2025
Same author

Predictors of Acute HCV Incidence in People with HIV: Insights from a Long-term Cohort Study.

Journal of acquired immune deficiency syndromes (1999)·2025

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pharmacovigilance

Background:

  • Coinfection with human immunodeficiency virus (HIV) and chronic hepatitis C virus (HCV) is common.
  • Antiretroviral therapy and antiviral treatments for HCV can have overlapping toxicities.
  • Mitochondrial toxicity is a known concern with certain nucleoside reverse transcriptase inhibitors.

Purpose of the Study:

  • To evaluate the risk of adverse events in patients with HIV and HCV coinfection receiving specific treatment regimens.
  • To identify potential drug-drug interactions leading to increased toxicity.
  • To inform clinical practice and regulatory actions regarding medication safety.

Main Methods:

  • Analysis of the US Food and Drug Administration's Adverse Event Reporting System (AERS) database.

Related Experiment Videos

  • Identification of patients coinfected with HIV and HCV.
  • Review of adverse events associated with ribavirin and didanosine, with or without stavudine treatment.

    • Main Results:

    • Coinfection patients on ribavirin and didanosine (with or without stavudine) showed a higher risk of mitochondrial toxicity.
    • Observed adverse events included fatal hepatic failure, peripheral neuropathy, pancreatitis, and symptomatic hyperlactatemia/lactic acidosis.
    • The US product labels for didanosine and ribavirin were updated to warn against this combination.

    Conclusions:

    • Coadministration of ribavirin and didanosine poses a significant risk of severe mitochondrial toxicity in HIV/HCV coinfected patients.
    • Healthcare providers should exercise caution and consider alternative regimens.
    • Regulatory action was taken to enhance patient safety through revised drug labeling.