Open AccessClinical Correlates to Muscle Biopsy Findings in HIV Patients Experiencing Fatigue: A case series
Author(s) -
Steven C. Zell,
Surl L. Nielsen
Publication year - 2002
Publication title -
journal of the international association of physicians in aids care
Language(s) - English
Resource type - Journals
eISSN - 1557-0886
pISSN - 1545-1097
DOI - 10.1177/154510970200100303
Subject(s) - medicine , muscle biopsy , liver biopsy , mitochondrial myopathy , biopsy , myopathy , creatine kinase , myositis , gastroenterology , pathology , mitochondrial dna , biochemistry , chemistry , gene
Muscular fatigue may result from HIV infection, and may be associated with antiretroviral drug treatment. Clinical features linked to muscle biopsy findings may assist in determining etiology, and guide treatment decisions. This case series examined HIV patients in an ambulatory HIV clinic who received antiretroviral therapy, and complained of unexplained muscular fatigue. Clinical features with measurement of acid-base status, levels of lactate, aminotransferases, triglycerides and creatine kinase were correlated to light and electron microscopic results of muscle biopsy. Three patients with acquired mitochondrial changes on biopsy shared common features of lactatemia, elevated aminotransferases and triglycerides, and ultrasonographic hepatic steatosis. A fourth patient with normal mitochondria had myositis with fibrosis, but no systemic symptoms. Biochemical parameters were unremarkable, except for a high creatine kinase. Acquired mitochondrial disease may manifest as systemic illness and muscular fatigue. Unique metabolic changes and other organ dysfunction may precede overt physical signs of HIV myopathy.