HIV gel breakthrough
By Health24 (South African Press Association) 9 February 2009: A study has found that a new vaginal gel called Pro2000 reduces the odds of HIV infection by 30 percent in women, says the Medical Research Council (MRC).
http://www.health24.com/news/HIV_AIDS/1-920,49564.asp
"For the first time since the epidemic we are seeing something that
would provide an option for women to prevent infection," principal
investigator Professor Gita Ramjee told journalists at the council's
branch in Chatsworth.
The results of the study were also presented at an international
meeting in Montreal, Canada on Monday.
The study, involving 3 099 women, was conducted between February 2005
and September 2008 in Malawi, South Africa, Zambia, Zimbabwe and the
United States.
Ramjee said two products were tested - Pro2000 and BufferGel.
During the course of the study, 194 infections occurred 36 infections
among women using Pro2000, 54 infections occurred among women using
BufferGel, 51 infections occurred among participants who were given a
placebo gel, while 53 infections occurred among participants who used
no gel.
Promising findings
"The trial found that women who were offered PRO2000 gel plus condoms
had 30 percent fewer HIV infections than those offered only condoms or
condoms plus a placebo gel," said the Global Campaign for Microbicides
(GCM) in a press release.
In another analysis that accounted for the time that women did not use
the products because they were pregnant, the study found PRO2000 to be
36% protective against HIV compared to the control arms. The other
candidate microbicide tested, BufferGel, did not reduce HIV risk among
women.
"The results on PRO2000 are a ray of hope for women," observed Lori
Heise, Director of GCM, an advocacy organisation that has been
campaigning to expand women's HIV prevention options for over a decade.
"This is the first time that we have had human data actually showing
that a vaginal gel can work to reduce infection. It's not a home run,
but this "proof of concept" should invigorate the field."
Another effectiveness trial of PRO2000, conducted by the UK-funded
Microbicide Development Programme (MDP), is currently in its final
stages in South Africa, Tanzania, Uganda and Zambia. This trial known
as MDP 301-has enrolled over 9 000 women, three times the number
enrolled in the current trial.
"This second trial should help us refine our estimate of how effective
PRO2000 actually is," noted Dr Samu Dube, GCM's Africa Program Leader.
With three times the number of women, the MDP trial will yield an even
more precise estimate of effectiveness. We will need such data before
deciding whether it makes sense to move this product forward toward
licensing and distribution."
Much remains to be done
"Much remains to be done before we will have a viable product to
distribute," notes Dube, "But as an African woman, a physician, and a
mother, my message is that this is a great day for women and for
prevention research."
Microbicides are substances designed to prevent or reduce the
transmission of HIV or other sexually transmitted infections.
Ramjee said the outcome of the study showed there was hope. "After
working for over a decade in microbicide research, we are seeing a
glimmer of hope of finding a safe and effective microbicide which could
protect women and substantially reduce new HIV infections here in South
Africa and globally."
Although no microbicides are approved or available for use, an
effective product could provide women with an HIV prevention method
which they can initiate, she said.
"This would be particularly helpful in situations where it is difficult
or impossible for women to negotiate condom use with their male
partners."
Women account for half of the 33 million people living with HIV/Aids
worldwide. In sub-Saharan Africa, women account for 60 percent of all
infected adults.
In several southern African countries, young women between the age of
15 and 24 are at least three times more likely than their male peers to
be infected with HIV.

