Nucleotide analogs such as dideoxynucleosides, AZT, 1 and d4T are widely used in clinics for their antiviral effects, in particular in the treatment of AIDS. Because the sugar moiety of these nucleoside reverse transcriptase inhibitors (NRTI) lacks a 3Ј-OH group, their incorporation by viral DNA polymerase or reverse transcriptase leads to DNA chain termination. To be substrates of DNA synthesis, an analog must first be converted to the 5Ј-triphosphate form, which is done intracellularly by kinases of the nucleoside salvage pathway. Whereas the first two phosphorylation steps are catalyzed by enzymes specific for the nucleobase, the ␥-phosphate is added by nucleoside diphosphate (NDP) kinase, which exhibits little specificity toward the nucleobase and the sugar moiety (1). The ␥-phosphate transfer from N 1 TP to N 2 DP catalyzed by NDP kinase involves a phosphohistidine intermediate,All eukaryotic NDP kinases are homohexamers with a 17-kDa subunit (2). In humans, where eight isoforms have been reported, the major isoforms NDPK-A and NDPK-B, respectively encoded by the genes nm23-H1 and nm23-H2, display 88% sequence identity and have very similar kinetic parameters (3). They closely resemble the NDP kinase from the lower eukaryote Dictyostelium discoideum (Dd-NDPK), which for most purposes is as a reliable model of other eukaryotic NDP kinases (4), easier to purify and crystallize than human NDP kinases. NDP kinases have a very high turnover rate on natural nucleotides, but their catalytic efficiency drops by a factor of 10 4 on the analogs AZT diphosphate or ddNDP (5). This is attributed to the substrate-assisted catalysis mechanism of NDP kinase, where the 3Ј-OH plays a major role. Using fluorescence stopped-flow experiments to study the two half-reactions (Reactions 1 and 2), we have previously shown that affinity is reduced 10-fold and phosphotransfer 500-to 1000-fold slower in the absence of the 3Ј-OH (6). The poor activation of NRTI by NDP kinase, resulting in low amounts of the triphosphate form of NRTI within infected cells, is of clinical importance. It is a major cause of incomplete suppression of viral DNA synthesis, allowing the selection of resistance mutations (7).To overcome this limitation, we designed new NRTIs with increased reactivity toward NDP kinase: the ␣-borano deriva-