Cytochrome c oxidase reaction improves histopathological assessment of zidovudine myopathy.

Abstract

Zidovudine can induce a mitochondrial myopathy with ragged-red fibers and partial cytochrome c oxidase deficiency. In an attempt to improve histological assessment of zidovudine myopathy, we evaluated cytochrome c oxidase histochemical reaction in the muscle of 10 patients with biopsy-proven zidovudine myopathy (Group 1), 10 myopathic zidovudine receivers without typical histopathological features of zidovudine myopathy (Group 2), and 10 human immunodeficiency virus (HIV)-infected patients not treated by zidovudine who had an immunohistological profile of HIV-associated myopathy or other neuromuscular disorders (Group 3). Among zidovudine receivers, cytochrome c oxidase deficiency was found in 10 of 10 patients from Group 1 and 7 of 10 from Group 2. No cytochrome c oxidase deficiency was observed in patients not treated by zidovudine. When present, cytochrome c oxidase-negative fibers accounted for 2 to 28% of fibers, and there was no difference for the number of cytochrome c oxidase-negative fibers between Group 1 and Group 2. Most patients with cytochrome c oxidase deficiency that could be evaluated clinically after muscle biopsy improved after withdrawal of zidovudine (5 of 7 in Group 1, 5 of 5 in Group 2). Patients who did not improve had an HIV-associated myopathy concurrently with zidovudine myopathy. We conclude that cytochrome c oxidase reaction may be used as a reliable marker of zidovudine mitochondrial toxicity in HIV-infected patients with muscular symptoms.

• Authors: P Chariot, I Monnet, R Gherardi
• Journal: Annals of neurology (Ann Neurol) Vol. 34 Issue 4 Pg. 561-5 (Oct 1993) ISSN: 0364-5134 [Print] United States
• PMID: 8215243 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Zidovudine

Topics

• Acquired Immunodeficiency Syndrome (drug therapy)
• Adult
• Aged
• Cytochrome-c Oxidase Deficiency
• Female
• Humans
• Male
• Middle Aged
• Mitochondrial Myopathies (chemically induced, enzymology, pathology)
• Zidovudine (adverse effects, therapeutic use)