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Bid to keep out HIV during sex
Pills known to treat AIDS patients may soon be turned into a preventive gel or vaginal ring that will block the HIV virus from infecting a woman during intercourse.The International Partnership for Microbicides (IPM) has embarked on large-scale studies to see if anti-retroviral therapy (ART) compounds, used to treat HIV, can be developed into potential microbicides to protect women from getting infected.
Six ART compounds and a class of therapeutics known as entry inhibitors, including Dapivirine, UC781, MIV150, CCR5, MLBMS and Tenofovir, known to be an effective treatment for HIV patients, are being turned into a viginal gel or ring that would release the drug gradually. IPM is keen to see if they can prevent the virus from entering the body.It is estimated that even a partially effective microbicide could prevent 2.5 million HIV infections over three years.Interestingly, in a first-ofits-kind agreement, three of the world’s leading pharma companies—Merck, Johnson & Johnson and Bristol-Myers Squibb—who make the six ART compounds, have signed a royalty-free licence with IPM allowing them to develop and distribute their compounds for use as microbicides in resource-poor countries.
IPM CEO Zeda Rosenberg said: “We are trying to develop a new generation of microbicides from known ART compounds. The AIDS virus has a high mutation rate and is known to replicate as soon as it enters the body. Known ART pills have to, therefore, wait for the person to get infected before they can stop the virus from replicating. What if the virus is resistant to any of the three drugs in the ART cocktail? It will continue to replicate. That’s why we are trying to see whether these known ART compounds can be made into a gel which, when put everyday, and a vaginal ring with a strong half life, which, when inserted once a month, can block the virus from entering a woman’s body.’’Dapivirine, which is undergoing safety and acceptability studies in Africa and Belgium, will be the first to undergo a large-scale efficacy study in 2008. India could be one of the sites for this study. Over 6,000 women, sexually active and in high-risk groups like sex workers, will be given the D-gel and D-ring and followed for a year to see if the microbicides blocked the AIDS virus. Final results are expected to come by 2010.
Rosenberg said: “The gel or the ring will cost much less than a pill. The latter needs to contain a good amount of drug to protect the body against HIV. Also, if a sexually-active woman, after getting infected, continues to consume ARTs prophalaxically, she would become resistant to the drug. A microbicide therefore will come as a boon.”