The pharmacokinetics of 2,3-dideoxyadenosine (ddA), didanosine, 2,3-dideoxyguanosine (ddG), and 6-halogenated prodrugs of ddG, 6-chloro-ddG and 6-iodo-ddG, in plasma and cerebrospinal fluid (CSF) were studied in a non-human primate model. ddA was rapidly and completely deaminated to didanosine, such that didanosine concentration profiles in plasma and CSF were identical following administration of ddA and didanosine. The mean clearance of didanosine was 0.50 liters/h/kg, the terminal half-life was 1.8 h, and the CSF-to-plasma ratio was 4.8%. The disposition of ddG was similar, with a clearance of 0.70 liters/h/kg and a half-life of 1.7 h. The adenosine deaminase-mediated conversion of the 6-halogenated-ddG prodrugs to ddG was rapid but incomplete (48% for 6-chloro-ddG and 29% for 6-iodo-ddG). The CSF-to-plasma ratios of ddG with equimolar doses of ddG, 6-chloro-ddG, and 6-iodo-ddG were 8.5, 24, and 17%, respectively, but the actual ddG exposures in CSF (area under the CSF concentration-time curve) were comparable for ddG (12.1 M ⅐ h) and the 6-halogenated-ddG prodrugs (18.8 M ⅐ h for 6-chloro-ddG, 9.3 M ⅐ h for 6-iodo-ddG). 6-Chloro-ddG was not detectable in plasma or CSF, and the CSF-to-plasma ratio of 6-iodo-ddG was 9.4%, so the higher CSF-to-plasma ratios of ddG with the administration of the 6-halogenated-ddG prodrugs does not appear to be the result of enhanced penetration of the prodrug and subsequent dehalogenation to ddG. The penetration of ddG into CSF exceeds that of didanosine and is enhanced by administration of the 6-halogenated prodrugs, although the mechanism of this enhanced penetration is unclear.The devastating effects of human immunodeficiency virus encephalopathy underscore the importance of finding new antiretroviral agents which penetrate into the central nervous system (CNS) to treat this important component of the disease (7). The currently approved antiretroviral drugs in clinical use are dideoxynucleoside analogs, including zidovudine, zalcitabine, and didanosine (ddI) (3). We previously studied the penetration of a series of dideoxypyrimidine nucleoside analogs into cerebrospinal fluid (CSF) and demonstrated that it ranged from over 20% for zidovudine to less than 5% for zalcitabine and that the degree of penetration into CSF was determined by the nucleobase rather than the alterations to the ribose sugar (5). In addition, in subsequent clinical trials the degree of drug penetration into CSF appeared to correlate with efficacy in treating AIDS dementia (19,20).A number of dideoxypurine (ddP) nucleoside analogs have also demonstrated antiretroviral activity in in vitro screening assays (14,15,17,21), and ddI was recently approved for clinical use. 2Ј,3Ј-Dideoxyadenosine (ddA) has a degree of activity similar to that of ddI, but it is almost instantaneously deaminated to ddI in vivo (9). A series of 6-halogenated 2Ј,3Ј-dideoxyguanosine (ddG) and ddI analogs which act as prodrugs of ddG and ddI are currently in the preclinical phase of drug development. The 6-halo-ddP analogs are more lip...