TreatmentUpdate40: - February 1993
Sean Hosein
A number of drugs "related" to AZT are being tested in experiments on animals and humans. One drug which may be beneficial to HIV-infected people is d4T or stavudine. The limited information which we have about d4T consists largely of data from experiments with cells, HIV, and animals. We also have preliminary results from experiments on people with HIV infection.
In the late 1980's researchers testing a number of anti-HIV drugs reported that d4T was able to reduce the production of HIV in experiments with cells. The anti-HIV activity of d4T was said to be at least equal to that of AZT. Compared to AZT, d4T was less toxic to cells of the bone marrow. In mice, infection with a certain retrovirus causes the equivalent of human AIDS, called MAIDS. In experiments on mice with MAIDS, d4T appeared to be a better anti-viral agent than AZT. In this "mouse model" of AIDS, AZT was thought to suppress the immune system of the mice in a number of ways. First, AZT appeared to suppress the production of protective anti-viral antibodies. Second, the drug reduced the activity of natural killer cells (NK). These cells are important in cancer control and also can perform anti-viral functions. AZT's suppressive effect on NK cells was described by researchers as being "profound". In contrast, d4T's overall effect on the immune systems of the mice was found to be "mildly" suppressive. The drug also appeared to protect NK cells from the immunosuppressive action of the retrovirus. This effect has been confirmed by other research teams.
1. Sidwell RW, Hitchcock M, Okleberry KM, et al. Suppression of murine retroviral disease by 2',3'-didehydro-2',3'dideoxythymidine (d4T). Antiviral Research 1992;19:313-324.
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