The (-) enantiomers of 2',3'-dideoxy-5-fluoro-3'-thiacytidine [(-)-FTC] and 2',3'-dideoxy-3'-thiacytidine [(-)-BCH-189] were recently shown to inhibit selectively human immunodeficiency viruses (HIV) and hepatitis B virus in vitro. In the current study, the potential for HIV type 1 (HIV-1) resistance to these compounds was evaluated by serial passage of the virus in human peripheral blood mononuclear cells and MT-2 cells in the presence of increasing drug concentrations. Highly drug-resistant HIV-1 variants dominated the replicating virus population after two or more cycles of infection. The resistant variants were cross-resistant to (-)-FTC, (-)-BCH-189, and their (+) congeners but remained susceptible to 2',3'-dideoxycytidine, 3'-azido-3'-deoxythymidine, 3'-fluoro-3'-deoxythymidine, 2',3'-dideoxyinosine, phosphonoformate, the TIBO compound R82150, and the bis(heteroaryl)piperazine derivative U-87201E. Reverse transcriptase derived from drug-resistant viral particles was 15- to 50-fold less susceptible to the 5'-triphosphates of FTC and BCH-189 compared with enzyme from parental drug-susceptible virus. DNA sequence analysis of the reverse transcriptase gene amplified from resistant viruses consistently identified mutations at codon 184 from Met (ATG) to Val (GTG or GTA) or Ile (ATA). Sequence analysis of amplified reverse transcriptase from a patient who had received (-)-BCH-189 therapy for 4 months demonstrated a mixture of the Met-184-to-Val (GTG) mutation and the parental genotype, indicating that the Met-184 mutation can occur in vivo.

Four different isomers of 2',3'-dideoxy-3'-thiacytidine [beta-DL-(+-)-BCH-189] were evaluated in primary human lymphocytes infected with human immunodeficiency virus type 1. The beta-L-(-) isomer was the most potent enantiomer, with a median effective concentration of 1.8 nM and no discernible cytotoxicity up to 100 microM. The relative order of potencies for the isomers was beta-L-(-) greater than beta-DL-(+-) racemic greater than beta-D-(+) greater than alpha-L-(+) greater than alpha-D-(-). The beta-L-(-) enantiomer was as potent as 3'-azido-3'-deoxythymidine.

A novel anti-hepatitis B virus (anti-HBV) agent, 2-fluoro-5-methyl-␤-L-arabinofuranosyluracil (L-FMAU), was synthesized and found to be a potent anti-HBV and anti-Epstein-Barr virus agent. Its in vitro potency was evaluated in 2.2.15 and H1 cells for anti-HBV and anti-Epstein-Barr virus activities, respectively. In vitro cytotoxicity in MT2, CEM, 2.2.15, and H1 cells was also assessed, and the results indicated high antiviral selectivities of L-FMAU in these cells.A number of nucleosides have been reported to be antihepatitis B virus (anti-HBV) agents, although none of them have yet been proven to be clinically useful. As a part of our antiviral drug discovery program for HBV, we recently have reported the syntheses and anti-HBV activities of dioxolane (14, 15) and oxathiolane (1,8,13) nucleosides. (Ϫ)-␤-L-Dioxolane-cytosine has been found to be the most potent anti-HBV agent (50% effective concentration ϭ 0.0005 M in 2.2.15 cells), although the compound was the most toxic (50% inhibitory concentration ϭ 0.26 M in CEM cells) among those tested (15). Among the oxathiolane cytosine nucleosides we evaluated, (Ϫ)-␤-L-oxathiolane-cytosine has the most potent anti-HBV activity (50% effective concentration ϭ 0.01 M) and a favorable cytotoxicity (Ͼ50 M in CEM cells) (1). Interestingly, the (Ϫ)-␤-L isomer of this compound resisted deoxycytidine deaminase, while the (ϩ)-␤-D isomer was deaminated under similar conditions (3).Recently, an increasing number of L nucleosides have been reported to be antiherpesvirus (23), anti-human immunodeficiency virus (anti-HIV) (2,6,13,14,16,19), and anti-HBV (1,7,8,10,11,15,16) agents. Furthermore, some of the L nucleosides have been found to be more potent than the corresponding D nucleosides (6,13,14). Previously, 2Ј-fluoro-5-methyl-␤-D-arabinofuranosyluracil (FMAU) and 2Ј-fluoro-5-ethyl-␤-Darabinofuranosyluracil (FEAU) were reported (5, 24, 27) to be extremely potent antiviral agents against herpesvirus and HBV, respectively. However, the myelosuppression and neurotoxicity of FMAU limit its usefulness as a clinically effective antiviral agent. In view of the discovery that several nucleosides with the unnatural L configuration are selective antiviral agents, it was of interest to synthesize several 2Ј-fluoro-substituted (arabino configuration) nucleosides with the L configuration as potential antiviral agents, anticipating that these nucleosides will give lower toxicities than the corresponding D isomers. Thus, we report here the preliminary syntheses and antiviral activities of several pyrimidine nucleosides for which the corresponding D isomers have been known to exhibit potent antiviral activities.Synthesis. 1-O-Acetyl-2,3,5-tri-O-benzoyl-␤-L-ribofuranose (compound 1) was prepared from L-ribose (Fig. 1). The fully protected L-ribose compound 1 was selectively debenzoylated at the C-2 position and then was converted to the 2-fluorinated sugar (compound 3) according to the method described for the corresponding D isomer (25). The 2-fluorosugar (arabino configuration) compound 3 was c...

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Since 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil (L-FMAU) has been shown to be a potent anti-HBV agent in vitro, it was of interest to study the structure-activity relationships of related nucleosides. Thus, a series of 1-(2-deoxy-2-fluoro-beta-L-arabinofuranosyl)pyrimidine nucleosides have been synthesized and evaluated for antiviral activity against HBV in 2.2.15 cells. For this study, L-ribose was initially used as the starting material. Due to the commercial cost of L-ribose, we have developed an efficient procedure for the preparation of L-ribose derivative 6. Starting from L-xylose, 6 was obtained in an excellent total yield (70%) through the pyridinium dichromate oxidation of the 3-OH group followed by stereoselective reduction with NaBH4. It was further converted to the 1,3,5-tri-O-benzoyl-2-deoxy-2-fluoro-alpha-L-arabinofuranose (10), which was then condensed with various 5-substituted pyrimidine bases to give the nucleosides. Among the compounds synthesized, the lead compound, L-FMAU (13), exhibited the most potent anti-HBV activity (EC50 0.1 microM). None of the other uracil derivatives showed significant anti-HBV activity up to 10 microM. Among the cytosine analogues, the cytosine (27) and 5-iodocytosine (35) derivatives showed moderately potent anti-HBV activity (EC50 1.4 and 5 microM, respectively). The cytotoxicity of these nucleoside analogues has also been assessed in 2.2.15 cells as well as CEM cells. None of these compounds displayed any toxicity up to 200 microM in 2.2.15 cells. Thus, compound 13 (L-FMAU), 27, and 35 showed a selectivity of over 2000, 140, and 40, respectively.