Treatment of primary HIV infection: a pilot study of stavudine and didanosine plus nevirapine with or without hydroxyurea

Treatment of primary human immunodeficiency virus (HIV) infection (PHI) may provide an opportunity to achieve a long lasting suppression of viral repl ication. Although there is growing evidence of the benefit of treating PHI, clinical data are still very limited. Special therapeutic considerations i n this clinical setting include the prevalence of resistant viruses in the community, complexity of regimens and their long-term toxicity. In addition , adjunctive therapies aimed at exploring the role of immune modulation and intensification of antiretroviral therapy are becoming areas of great inte rest. In this regard, the role of hydroxyurea, a cytostatic agent that pote ntiates the antiviral effect of didanosine, and possibly of stavudine is be ing investigated. A pilot study to assess the antiviral effect of a combina tion of didanosine plus stavudine plus nevirapine with or without hydroxyur ea in the treatment of PHI is currently under way. Preliminary results on 2 2 patients who completed at least 36 weeks of therapy suggest that the comb ination is safe, well tolerated and effective for the treatment of PHI.