Could mitochondrial DNA quantitation be a surrogate marker for drug mitochondrial toxicity?

Nucleoside reverse transcriptase inhibitors have been proven to inhibit mitochondrial DNA (mtDNA) polymerase gamma, resulting in decreased mtDNA synthesis and consequential risk for the development of mitochondrial dysfunction in HIV-infected individuals. The depletion of mtDNA seems to correlate with the development of symptomatic hyperlactatemia and lipoatrophy. A validated quantitative mitochondrial DNA assay could be useful to monitor and prevent mitochondrial damage in HIV-infected patients, especially in those under antiretroviral therapy with nucleoside analogues. This review analyzes the current methods to determine mitochondrial damage and the available data to support their utility in clinical practice.