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Published on: October 2, 2009
Disfunción mitocondrial persistente y exposición perinatal a los análogos de nucleósidos antirretrovirales
S Blanche1, M Tardieu, P Rustin
1Service d'Immunologie Hématologie Pédiatrique and INSERM U429 Laboratory, Hôpital Necker, Paris, France. stephane.blanche@nck.ap-hop-paris.fr
Lancet (London, England)
|October 6, 1999
Resumen
La exposición perinatal a zidovudina, un análogo de nucleósidos, puede causar disfunción mitocondrial en los bebés. Se necesita más investigación para evaluar los efectos tóxicos de estos medicamentos antirretrovirales.
Área de la Ciencia:
- Farmacología Pediátrica.
- La medicina mitocondrial es la medicina de las mitocondrias.
- Virología Virología.
Sus antecedentes:
- La zidovudina es un medicamento clave para prevenir la transmisión del VIH-1 de madre a hijo.
- Se investigaron los posibles efectos tóxicos mitocondriales en niños expuestos a zidovudina.
- Concéntrese en las rutas de exposición in utero y postnatal.
Objetivo del estudio:
- Para investigar los efectos tóxicos mitocondriales en lactantes expuestos a zidovudina.
- Para analizar los síntomas clínicos y biológicos de la disfunción mitocondrial.
- Para evaluar la seguridad de la administración de análogos de nucleósidos durante el embarazo.
Principales métodos:
- Análisis retrospectivo de datos clínicos y biológicos de mujeres infectadas por el VIH-1 en Francia.
- Niños examinados expuestos a zidovudina sola o en combinación con lamivudina.
- Disfunción mitocondrial evaluada mediante espectrofotometría y polarografía de complejos de la cadena respiratoria.
Principales resultados:
- Ocho niños exhibieron signos de disfunción mitocondrial.
- Cuatro niños expuestos a zidovudina sola, cuatro a zidovudina y lamivudina.
- Las actividades anormales del complejo de la cadena respiratoria (I, IV o ambas) persistieron mucho tiempo después de la interrupción del tratamiento.
Conclusiones:
- Los hallazgos sugieren un vínculo entre la administración de análogos de nucleósidos perinatales y la disfunción mitocondrial.
- Las recomendaciones actuales de monoterapia con zidovudina deben continuar.
- Es esencial una mayor evaluación de la toxicidad de los medicamentos antirretrovirales.
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