Thursday, December 18, 2008

Buzzzzzz --- Rectal Microbicides!

by Mariama Kamara (African HIV Policy Network, UK)

and Dr. Carolina Herrera (St. George’s University, London, UK)

Our third Buzz Café ( hosted by the UK African Microbicides Working Group on December 4) focused on rectal microbicides and the possibilities of having a rectal Microbicides before a vaginal one. The topic in itself is quite controversial but it was a space for advocates to discuss and enhance their knowledge of rectal microbicide research and development. Anal intercourse is increasingly understood as a more common practice amongst heterosexuals. Dr Carolina Herrera from St George’s University shared information about their recent research findings on rectal microbicides and what they have accomplished over the past four years.

To date the National Institutes of Health (NIH) and amfAR have funded for the first time, projects aiming to develop rectal microbicides and efforts to understand colorectal transmission of HIV. The laboratories of Professor Robin Shattock and Martin Cranage at St. George’s, University of London have been involved in both projects.

A laboratory model of the colorectal tract based on little pieces of tissue, known as explants, and obtained from surgery has been developed. This model allows screening of compounds, to test possible combinations of compounds and to determine possible inflammatory responses of the tissue after exposure to compounds and their possible formulations. Furthermore, it gives the possibility to assess the replication capacity of resistant isolates against different compounds and to measure the early responses of the tissue to viral exposure. Understanding the mechanism of HIV-1 transmission in the colorectal tract and determining the best combinations of compounds to inhibit resistant isolates will be key to the design of successful prevention strategies. This funding has allowed the first Phase 1 trial of a reverse transcriptase inhibitor, UC781, in vaginal formulation applied rectally; and next year, another Phase 1 trial will be conducted with PMPA/Tenofovir, again in the vaginal formulation and applied rectally.

The Buzz Café brought together ideas from scientists and advocates about working more closely together and sharing new research ideas to further understanding amongst both groups and contribute to informed advocacy for microbicides research.

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