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dysfunction is more common in people with HIV (PWH) than those without HIV (PWoH), with mitochondrial dysfunction implicated in pathogenesis. We investigated whether variations in mitochondrial DNA (mtDNA) and certain dideoxynucleoside analogs (D-drugs) relate to left ventricular diastolic dysfunction (LVDD) in PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included individuals with echocardiograms from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study. LVDD was defined using characterizing heart function on antiretroviral therapy criteria. mtDNA haplogroups were inferred using HaploGrep. Separate exploratory multivariable logistic regressions examined associations between LVDD and African (L0L1, L2, L3, or \u201cother\u201d) or European haplogroups (UK, H, JT, or \u201cother\u201d), D-drugs, and their interactions. No adjustments were made for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 842 men (455 PWH and 387 PWoH) and 898 women (620 PWH and 278 PWoH), LVDD prevalence was 29% in women and 24% in men. Among non-Hispanic White men with HIV, European haplogroup H was associated with lower odds of LVDD (odds ratio [OR], 0.50; 95% CI, 0.26\u20130.93), while haplogroup clade JT was associated with increased odds (OR, 2.09; 95% CI, 1.00\u20134.36). In men with HIV, D-drug exposure was associated with increased odds of LVDD (OR, 1.94; 95% CI, 1.21\u20133.13). No significant associations were observed between haplogroups and LVDD in women. HIV serostatus modified the association of haplogroup L2 (pinteraction = 0.036) and L3 (pinteraction = 0.045) with LVDD in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mitochondrial genetic variation and D-drug use were associated with altered LVDD risk in men with HIV, highlighting potential biological mechanisms that may be targeted for surveillance or therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag090","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:35:11Z","timestamp":1770726911000},"page":"e1423-e1432","source":"Crossref","is-referenced-by-count":2,"title":["Mitochondrial Haplogroups and Left Ventricular Diastolic Dysfunction in People Living With and Without HIV"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7086-3818","authenticated-orcid":false,"given":"Craig","family":"Cronin","sequence":"first","affiliation":[{"name":"Department of Medicine, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3741-0962","authenticated-orcid":false,"given":"Jing","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-7803","authenticated-orcid":false,"given":"Jorge R","family":"Kizer","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), San Francisco Veterans Affairs Health Care System and University of California, San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4958-5145","authenticated-orcid":false,"given":"Katherine C","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8655-5204","authenticated-orcid":false,"given":"Wendy S","family":"Post","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health University , Baltimore, Maryland ,","place":["USA"]},{"name":"Department of Medicine (Cardiology), Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Samuels","sequence":"additional","affiliation":[{"name":"Department of Molecular Physiology and Biophysics, Vanderbilt School of Medicine , Nashville, Tennessee ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3339-067X","authenticated-orcid":false,"given":"Todd","family":"Hulgan","sequence":"additional","affiliation":[{"name":"Department of Medicine (Infectious Diseases), Vanderbilt University Medical Center , Nashville, Tennessee ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Aouizerat","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, New York University , New York, New York ,","place":["USA"]},{"name":"Translational Research Center, College of Dentistry, New York University , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Palella","sequence":"additional","affiliation":[{"name":"Department of Medicine (Infectious Diseases), Northwestern University , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehnaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, School of Medicine and Comprehensive Cancer Center, University of California, Davis , Davis, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4673-7238","authenticated-orcid":false,"given":"Jeremy","family":"Martinson","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6483-4560","authenticated-orcid":false,"given":"Nicole D","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), University of Miami Miller School of Medicine , Miami, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin A","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Medicine (Infectious Diseases), Emory University School of Medicine , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3262-5668","authenticated-orcid":false,"given":"Alan","family":"Hinderliter","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), University of North Carolina at Chapel Hill , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmeen","family":"Golzar","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), Cook County Health , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1744-5271","authenticated-orcid":false,"given":"Federico M","family":"Asch","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), MedStar Health Research Institute, MedStar Washington Hospital Center , Washington, DC ,","place":["USA"]},{"name":"Department of Medicine, Georgetown University School of Medicine , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Lazar","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), SUNY Downstate Health Sciences University , Brooklyn, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos J","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), Albert Einstein College of Medicine , Bronx, New York ,","place":["USA"]},{"name":"Department of Epidemiology, Albert Einstein College of Medicine , Bronx, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8599-278X","authenticated-orcid":false,"given":"Todd T","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health 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