This podcast provides further insights on mitochondrial pathology resulting from long-term treatment of patients infected with human immunodeficiency virus using cocktails of nucleoside analog reverse transcriptase inhibitors (NRTIs).  The respondent is Dr. Brendan Payne, a clinician at the Institute of Genetic Medicine, Newcastle University, Newcastle-upon-Tyne, UK with an interest in diagnosis and treatment of infectious disease--and specifically human immunodeficiency virus (HIV); Dr. Payne is the senior author of a recent review article, "HIV Treatment and Associated Mitochondrial Pathology: Review of 25 Years of In Vitro, Animal, and Human Studies."  Dr. Payne's research suggests that the cumulative exposure to NRTIs is more important than the peak levels, indicating that the usual design of animal experiments (short terms with high doses, histopathology as a major endpoint) to model human responses may understate or even miss the consequences to patients who may be expected to remain on cocktails of these agents for life.  Dr. Payne describes the utility of various test modalities as potential means for detecting mitochondrial damage when such an outcome is suspected.
 
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