Thursday, July 17, 2008

Microbicides could prevent more infections in men than in women

Microbicides intended for vaginal use by women that contain non-nucleoside (NNRTI) antiretroviral drugs could end up preventing more infections in men than women, a mathematical model devised by biostatisticians from universities in Sydney, Montreal, Philadelphia and Los Angeles has found.

This paradoxical outcome might arise, the researchers say, because use of microbicides containing NNRTIs could result in a significant number of NNRTI-resistant HIV infections, especially if there is significant absorption into the body of women using them. Furthermore; because drug-resistant virus is often less fit than wild-type virus, female-to-male transmission would be less likely to occur. Men would also benefit more directly if the microbicide was ‘bi-directional’ and provided some protection for a man having sex with a women with HIV who was using it.

Microbicides containing antiretrovirals are being developed as a new generation of products following the failure of earlier types of microbicides. Antiretrovirals not in use for treatment of people with HIV are being investigated for their preventive potential when delivered within a gel for vaginal or rectal use. However, there are concerns that if the antiretroviral drug is absorbed into the body at low levels, the drug could give rise to resistance in people who are already infected with HIV. This is especially true for NNRTIs, where resistance to the currently licensed drugs in this class is quick to develop.

Read the rest of this article, by Gus Cairns, writing for Aidsmap.

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