Role of hydroxyurea in treatment of disease due to human immunodeficiency virus infection

The potential role of hydroxyurea in the treatment of human immunodeficienc y virus (HIV) infection was first supported by in vitro experiments that de monstrated control of viral production in activated and resting T cells. Mo re recently controlled clinical trials demonstrated that the addition of hy droxyurea to nucleoside-including regimens (chiefly of didanosine but also of stavudine and lamivudine) enhances their antiviral potency. It is believ ed that the cytostatic effect of hydroxyurea is at least partially responsi ble for its antiviral effect, through the down-modulation of cellular proli feration. Such an effect has also been credited for the blunted CD4 T cell responses that are characteristically observed when hydroxyurea is added to nucleoside-including regimens. The adjunctive antiviral effect of hydroxyu rea-as well as its favorable dosing schedule, safety profile, and cost-make s it a. very attractive addition to our therapeutic armamentarium. Further research is urgently needed to delineate the most appropriate use of this c ompound in the setting of HIV antiretroviral therapy.