OPHTHALMOPLEGIA AND PTOSIS: MITOCHONDRIAL TOXICITY IN PATIENTS RECEIVING HIV THERAPY

Mitochondrial toxicity (MT) can occur as a consequence of HIV infection and from treatment with highly active antiretroviral therapy (HAART).1 Toxicity is additive and manifested by signs including lipodystrophy and lactic acidosis. HIV and HAART are also reported in association with skeletal myopathy and mitochondrial abnormalities on muscle biopsy.2 This is in contrast to mitochondrial disorders associated with nuclear or mitochondrial DNA (mtDNA) mutations, in which patients may present with syndromic constellations of dysfunction in metabolically active tissues such as the brain and skeletal muscles. Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial syndrome with gradual onset of ptosis and ophthalmoparesis.3 Thus far, phenotypes resembling genetic mitochondrial disorders have not been reported in association with acquired mitochondrial toxicity from disease or drugs. We report 3 cases of HIV-infected patients with long exposure to HAART who developed clinical syndromes resembling CPEO. ### Case series. See the table for details. The patients were men, between the ages of 52 …