Hydroxyurea for HIV infection

Hydroxyurea, an inhibitor of DNA synthesis, is used to treat HIV infection. By inhibiting ribonucleotide reductase, hydroxyurea depletes the pool of deoxynucleoside triphosphates, particularly dATP, available for DNA synthesis. Hydroxyurea may be a candidate for use with nucleoside analogs, particularly ddI. Hydroxyurea's use in treating HIV infection with and without ddI, with ddI and without d4T, and with ddI plus a protease inhibitor are discussed. Studies using hydroxyurea with ddI and d4T have shown clinical promise and could be a viable antiretroviral strategy in some patients, especially in countries with limited resources. A regimen containing hydroxyurea, ddI, and a protease inhibitor could be used in aggressive initial or salvage antiretroviral therapy. It is also possible that during acute HIV infection, hydroxyurea's cytostatic properties could contribute to the ultimate preservation of normal immunologic function. Hydroxyurea's dosage level is still uncertain; 500 mg twice daily has been used most often.