HIV-associated mitochondrial toxicity in pregnancy.

Pregnancy is associated with a variety of physiologic and metabolic changes designed to support the fetoplacental unit. In the presence of maternal human immunodeficiency virus (HIV) infection, the use of combination antiretroviral therapy including the nucleoside analog reverse transcriptase inhibitor (NRTI) zidovudine to prevent perinatal HIV transmission, has resulted in a dramatic decrease in perinatally acquired HIV. Human and animal studies during pregnancy report a possible association between NRTI containing antiretroviral regimens and mitochondrial toxicity in the newborn and mother. However, the possible long-term consequences on the fetus and mother of these NRTI containing regimens during pregnancy are largely unknown. This review will examine the data available on NRTI-induced mitochondrial toxicity associated with combination antiretroviral regimens used to prevent perinatal HIV transmission.