Prioritizing prevention of HIV and sexually transmitted infections: First-generation vaginal microbicides

Rebecca Pellett Madan, Marla J. Keller, Betsy Herold

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose of review: As the HIV/AIDS pandemic continues unabated, novel control measures for the spread of HIV and other sexually transmitted infections are urgently needed. Topical microbicides are designed to prevent transmission of sexually transmitted infections when applied vaginally. The microbicides discussed in this review may provide a new opportunity for decreasing the spread of HIV and other sexually transmitted infections. Recent findings: Epidemiological studies suggest a synergistic relationship between HIV and sexually transmitted infections, particularly between HIV and genital herpes infection. Compounds have been developed to block transmission of HIV-1 and herpes simplex virus, as well as Neisseria gonorrhoea and Chlamydia trachomatis. Several of these compounds have advanced to clinical trials as candidate microbicides. Candidate compounds fall into the following categories: detergents or surfactants that inactivate viral particles, anionic polymers that block attachment of virus to target cells, vaginal acid-buffering agents that maintain a protective vaginal pH, and antiretroviral drugs specific for HIV. Evaluation of the safety of topical microbicides remains problematic. Clinical experiences indicate that current models to assess safety in vitro and in vivo may be insufficient to assess the safety of vaginal microbicides. A critical direction of future studies is to identify which assay(s) provide surrogate laboratory markers of safety that correlate with clinical outcomes. Summary: The spread of HIV, and its increasing burden of disease in women, necessitates the development of novel prophylactic strategies. Topical microbicides offer women an empowering preventative option but require vigorous testing for safety and effectiveness.

Original languageEnglish (US)
Pages (from-to)49-54
Number of pages6
JournalCurrent Opinion in Infectious Diseases
Volume19
Issue number1
StatePublished - Feb 2006

Fingerprint

Sexually Transmitted Diseases
Anti-Infective Agents
HIV
Local Anti-Infective Agents
Safety
Biomarkers
Virus Attachment
Herpes Genitalis
Neisseria gonorrhoeae
Chlamydia trachomatis
Pandemics
Simplexvirus
Surface-Active Agents
Virion
Detergents
HIV-1
Epidemiologic Studies
Polymers
Acquired Immunodeficiency Syndrome
Clinical Trials

Keywords

  • Genital herpes
  • Herpes simplex virus
  • Human immunodeficiency syndrome
  • Sexually transmitted infections
  • Topical microbicides

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Prioritizing prevention of HIV and sexually transmitted infections : First-generation vaginal microbicides. / Madan, Rebecca Pellett; Keller, Marla J.; Herold, Betsy.

In: Current Opinion in Infectious Diseases, Vol. 19, No. 1, 02.2006, p. 49-54.

Research output: Contribution to journalArticle

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