Increased mitochondrial toxicity with ribavirin in HIV/HCV coinfection

In two of 15 patients coinfected with HIV and hepatitis C virus who received interferon-α plus ribavirin in addition to HAART, we observed multiorgan dysfunction and lactic acidaemia. As ribavirin is a nucleoside analogue, an increased risk of mitochondrial toxicity can be induced in HIV-infected patients already treated with nucleoside analogues, leading to clinical deterioration in some cases.