AIDS gels may work, but weakness seen in cocktails - Update 2
By Maggie Fox, Health and Science Editor (Reuters - Washington) 9 February 2009: Researchers trying to find a way to protect women from the AIDS virus said on Monday they had the first evidence that protective gels might work.
www.reuters.com/article/governmentFilingsNews/idUSN0951751020090209
But two studies show that men who take powerful anti-HIV drug
cocktails may still pass the virus on in their semen, even if it cannot
be found by blood tests.
The studies presented at a meeting of AIDS experts in Canada show slow
progress in finding ways to slow the pandemic of deadly human
immunodeficiency virus, which infects 33 million people globally and
which has killed 25 million.
Dr. Salim Abdool Karim of the Center for the AIDS Program of Research
in South Africa and colleagues tested a gel made by Massachusetts-based
Indevus Pharmaceuticals (IDEV.O) called PRO 2000 in a study involving
3,000 women.
They are trying to find a microbicide -- a gel or cream that women and
perhaps men can use to protect against the AIDS virus when their
partners cannot or will not use a condom.
PRO 2000 reduced the rate of HIV infection by a third, they told the
meeting. "This is the first study that now shows that we have a
promising candidate," Karim told a news conference at the Conference on
Retroviruses in Montreal.
"We do not regard it as a definitive conclusion that PRO 2000 is a
microbicide but we certainly view it as very promising."
His team tested another microbicide called BufferGel made by ReProtect
Inc, but were unable to find any significant sign that it helped. The
study was only designed to show the gels were safe, an especially
important issue because other studies have shown would-be microbicides
actually raised the risk of infection.
DRUGS AS PROTECTION
Two studies in monkeys showed combinations of Gilead Sciences Inc.'s
(GILD.O) HIV drug Viread, or tenofovir, with its newer drug
emtricitabine, marketed under the brand name Truvada, could protect
monkeys from infection with a monkey virus similar to HIV both as a gel
or in pills.
Dr. Gerardo Garcia-Lerma and colleagues at the U.S. Centers for Disease
Control and Prevention gave Truvada pills to monkeys in an approach
called pre-exposure prophylaxis and found the monkeys were protected by
a single dose even up to three days before exposure to HIV.
CDC's Drs. Charles Dobard and Walid Heneine treated monkeys with one of
two gels, one containing Viread alone and one with both drugs. Either
gel worked equally well in protecting the monkeys, they told the
meeting.
But two studies showed that men who take drug cocktails known as highly
active antiretroviral therapy or HAART can still pass the virus in
their semen.
Prameet Sheth of the University of Toronto in Canada and Anne-Genevieve
Marcelin of the Pitie-Salpetriere in Paris both found that men whose
blood seemed clear of HIV nonetheless had some in their semen.
"I would argue that it is infectious although we don't know what
level of virus is required," Sheth told the news conference.
The drug cocktails do not cure AIDS, but drive down levels of the virus
to undetectable levels in blood. This helps stop the virus from
destroying the immune system and keeps patients healthy.
The hope had been they would reduce the spread of AIDS, and on a
population level that may still be true, the researchers told the
meeting.
It was not clear why the virus could be found in semen but not in blood
but experts know it is impossible to completely suppress the
virus.

