Clinical use of hydroxyurea in HIV-1 infected patients

Emerging drug resistance and side effects complicate the clinical care of H IV-infected patients. Accumulating data from basic science and clinical stu dies suggest that hydroxyurea-based regimens are effective treatment option s for patients at various stages of disease. Review of the clinical studies confirms that hydroxyurea-based regimens produce potent and sustained vira l suppression, with an unexpected high degree of tolerability, in patients with primary and chronic HIV infection. Hydroxyurea, the first antiretrovir al drug targeting a cellular factor, represents a novel and inexpensive app roach to combination therapy for HIV infection. Hydroxyurea is not prone to resistance while impeding resistance to reverse transcriptase inhibitors. The cytostatic properties of hydroxyurea may contribute to its immunomodula tory effects while reducing activated HIV target cells. These characteristi cs make hydroxyurea a good candidate for long-term treatment of HIV infecte d individuals. Future studies including those that evaluate optimal dosing a long-term use will continue to define the role for this agent in the trea tment of HIV infection.