Drug-Induced Mitochondrial Cardiomyopathy and Cardiovascular Risks in Children

This chapter describes the mechanisms and the short- and long-term consequences of human immunodeficiency virus (HIV) medications and cancer chemotherapies that are associated with mitochondrial dysfunction and its cardiac consequences in children. Adults and children with HIV are living longer because of advances in antiretroviral therapy (ART). Mitochondrial dysfunction secondary to ART is drug and organ specific. This specificity was first described in 1988, in HIV patients treated with high doses of the nucleoside reverse transcriptase inhibitor (NRTI), zidovudine. One of the major successes of pediatric oncology is that children with childhood cancers are living substantially longer and healthier lives because of advances in chemotherapeutic agents. Chemotherapeutic medications are designed to interfere with rapidly dividing neoplastic cells. However, in the process, they can adversely affect normal cell division, especially in tissues with rapid turnover.