Mitochondrial thymidine kinase 2 (TK2) and deoxyguanosine kinase (dGK) catalyze the initial phosphorylation of deoxynucleosides in the synthesis of the DNA precursors required for mitochondrial DNA (mtDNA) replication and are essential for mitochondrial function. Antiviral nucleosides are known to cause toxic mitochondrial side effects. Here, we examined the effects of 3=-azido-2=,3=-dideoxythymidine (AZT) (zidovudine) on mitochondrial TK2 and dGK levels and found that AZT treatment led to downregulation of mitochondrial TK2 and dGK in U2OS cells, whereas cytosolic deoxycytidine kinase (dCK) and thymidine kinase 1 (TK1) levels were not affected. The AZT effects on mitochondrial TK2 and dGK were similar to those of oxidants (e.g., hydrogen peroxide); therefore, we examined the oxidative effects of AZT. We found a modest increase in cellular reactive oxygen species (ROS) levels in the AZT-treated cells. The addition of uridine to AZT-treated cells reduced ROS levels and protein oxidation and prevented the degradation of mitochondrial TK2 and dGK. In organello studies indicated that the degradation of mitochondrial TK2 and dGK is a mitochondrial event. These results suggest that downregulation of mitochondrial TK2 and dGK may lead to decreased mitochondrial DNA precursor pools and eventually mtDNA depletion, which has significant implications for the regulation of mitochondrial nucleotide biosynthesis and for antiviral therapy using nucleoside analogs. N ucleoside analogs are widely used as antiviral and anticancer agents, and today Ͼ50% of the FDA-approved antiviral and anticancer drugs are nucleoside or nucleobase analogs. These analogs are administered as prodrugs that need to be activated by cellular enzymes to exert their therapeutic potential. Deoxynucleoside kinases catalyze the initial phosphorylation of nucleoside analogs; once phosphorylated, these nucleotides are trapped inside the cell and are further metabolized to their active forms, which interact with the final targets. There are four deoxynucleoside kinases in mammalian cells, i.e., cytosolic thymidine kinase 1 (TK1) and deoxycytidine kinase (dCK) and mitochondrial thymidine kinase 2 (TK2) and deoxyguanosine kinase (dGK) (1, 2). Recent studies using TK1-and dCK-knockout mouse models indicate that cytosolic TK1 and dCK regulate hematopoiesis by linking salvage deoxynucleotide synthesis and replication stress (3, 4). The mitochondrial enzymes TK2 and dGK are vital for mitochondrial function, because deficiency in either causes severe mitochondrial DNA (mtDNA) depletion syndrome (MDS) in human patients and in TK2-knockout mouse models (5-8). TK2 has also been shown to play an important role in providing dTTP for nuclear DNA repair and thus genomic stability in quiescent cells (9).The nucleoside analogs used in antiviral and anticancer therapy are often associated with mitochondrial toxicity. Mitochondrial myopathy, cardiomyopathy, and lipodystrophy associated with anti-HIV treatment using zidovudine (AZT) or 2=,3=-dideoxyinosine (ddI) (didanosine) wer...