Trial for new microbicide starts in South Africa

Durban - Researchers in the province of KwaZulu-Natal have begun recruiting women in South Africa for the first trials worldwide of a vaginal gel containing an antiretroviral drug tenofovir, which they hope will protect women from HIV infection, according to SciDev.net.

Microbicides are part of the New Prevention Technologies (NPTs) that are being brought into play to stop the spiralling spread of HIV among women, because of women's low social economic status and lack of decision-making in sexual matters. HIV infections rates have been increasing among women in recent years. Women make up 60% of the infected.

Women affairs Ministers meeting in Kampala in mid June called for more funding in research of microbicides, substances that can be applied topically in the vagina before sexual intercourse to prevent HIV infection and other sexually transmitted infections.

Dr. Florence Mirembe, a gynaecologist from Makerere University, said that microbicides, which women can apply without asking for permission from their partners, have potential to prevent HIV infection in both men and women by creating a mechanical barrier, prevention of multiplication, directly killing the virus and bringing about an immune reaction.

Third generation, and unique

According to SciDev, a total of 980 women will be enrolled at two sites in KwaZulu-Natal, one urban and one rural; and results, which are expected in 2010, will indicate if the tenofovir gel offers protection against HIV.

Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa (CAPRISA), which is running the trials, says that the current oral use of tenofovir is highly effective and safe, and that tenofovir microbicide differs from previous microbicides.

"Tenofovir gel is a third generation microbicide and is unique in that it works within cells to stop HIV from replicating. The second generation polymer microbicides, tried to kill off or block the HIV from entering cells," he told SciDev.

Karim says that animal studies have shown that when given a rectal tenofovir, monkeys were protected from simian immunodeficiency virus, a virus that is similar to HIV.

Researchers say that if found effective, women would be able to use tenofovir gel for up to 12 hours before sex and within 12 hours after sex, ensuring maximum protection for HIV infection, the disease that caused more than 2million unavoidable deaths last year.

Before a cure vaccine for HIV is found, microbicides provide the greatest hope for women to protect themselves against HIV infection in situations where they have little negotiating power to persuade male partners to use condoms, or enforce faithfulness.

The new trials for microbicides will provide the hope needed by many women, after previous cellulose sulphate microbicide trials in Uganda, Benin, India and South Africa were stopped in January 2007 when some women failed to take the treatment and others became infected with HIV, the virus that causes AIDS.

Article courtesy of The Zimbabwean