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While standardized clinical assays are still needed, integrating mtDNA metrics into patient management holds promise for advancing personalized medicine in HIV care, shifting the focus from viral suppression to the optimization of metabolic and immunological health 7 Therapeutic strategies targeting mitochondria and mtDNA The recognition of mitochondrial dysfunction as a cornerstone of HIV pathogenesis and ART-related toxicity has catalyzed the search for therapeutic strategies aimed at preserving or restoring mitochondrial health