May #91 : Double Agent - by David Gelman, MD

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May 2003

Double Agent

by David Gelman, MD

If the Hatfields and McCoys found some kin in common, would they lock up their shotguns? So it might go for GlaxoSmithKline’s AZT (Retrovir) and Bristol-Myers Squibb’s d4T (Zerit), longtime nuke rivals. A recent AIDS Journal study looked at the cells of folks on AZT and found significant levels of…d4T! Seems the dueling drugs have kissing-cousin chemical structures, and the body converts some of the AZT to d4T. “This would help explain the overlap in resistance between the two drugs and why there’s so much confusion around what’s involved with fat loss,” says veteran New York City HIV doc Howard Grossman, referring to recent research that fingers both drugs (but d4T more so) for lipodystrophic laments like “puppet cheeks.” Still, actual levels of d4T in the cells of the study’s AZT-takers varied widely. Could comparing high-level and low-level folks yield the next piece of the puzzle? Don’t y’all pawn your pea-shooters yet, y’hear?  




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