Oxandrolone, used for treatment of wasting disease in HIV-1-infected patients, does not diminish the antiviral activity of deoxynucleoside analogues in lymphocyte and macrophage cell cultures

Antiviral agents are the primary therapy for patients infected with HIV-1. However, supportive therapies are often necessary in addition to antiviral drugs because of the devastating wasting process associated with HIV-1 infe ction and AIDS. Oxandrolone, an anabolic steroid, is used in promoting weig ht gain and, most important lean body mass (LBM), in patients with HIV-1 di sease. We investigated whether oxandrolone interferes with the antiviral ac tivity of zidovudine (ZDV), dideoxyinosine (ddI), and dideoxycytidine (ddC) on HIV-1 replication in peripheral blood lymphocytes and macrophage-monocy tes. The nucleoside analogues had nanomolar 50% inhibitory concentrations ( IC50) in peripheral lymphocytes. Combinations of nucleoside analogues and o xandrolone did not result in increased IC50 values. Oxandrolone used alone exhibited micromolar IC50 values in peripheral blood lymphocytes. Lack of i nterference was consistent for nucleoside concentrations up to 5 mu M and f or oxandrolone concentrations up to 100 mu M in several combinations of dru gs, viral strains, and peripheral lymphocytes and macrophages. We conclude that oxandrolone can be used for the promotion of weight gain in patients w ith AIDS-related wasting without interference with the antiviral effects of ZDV, ddI, or ddC.