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Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection.
J Infect Dis. 2006 Jan 01; 193(1):36-44.JI

Abstract

BACKGROUND

Microbicides are topical compounds that could prevent sexually transmitted infections. Several compounds have demonstrated activity both in vitro and in animal models, but none has been approved for use in humans.

METHODS

A review of >100 recent publications from MEDLINE (through October 2005) and abstracts presented at recent conferences was undertaken to describe the current status of microbicide research and to delineate why microbicides are not yet available.

RESULTS

More than 15 candidate microbicides are currently being studied in clinical trials. Their mechanisms of action include disruption of the viral membrane by surfactants, maintenance of an acidic vaginal pH, binding to the viral envelope to block receptor binding, and blocking of receptors; they may also be combined with antiretroviral drugs. The development of safe and effective microbicides has been delayed by limitations in understanding the biological processes of human immunodeficiency virus (HIV) transmission, difficulties in extrapolation from animal models, lack of established correlates of protection, and the need to enroll and follow large cohorts of high-risk participants for several years in order to demonstrate efficacy.

CONCLUSIONS

Safe and effective topical microbicides are biologically plausible. Several trials that are under way may demonstrate the ability of microbicides to protect against transmission of HIV, but multiple challenges remain.

Authors+Show Affiliations

Brown Medical School, Brown University, Providence, RI 02906, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

16323129

Citation

Dhawan, Darpun, and Kenneth H. Mayer. "Microbicides to Prevent HIV Transmission: Overcoming Obstacles to Chemical Barrier Protection." The Journal of Infectious Diseases, vol. 193, no. 1, 2006, pp. 36-44.
Dhawan D, Mayer KH. Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection. J Infect Dis. 2006;193(1):36-44.
Dhawan, D., & Mayer, K. H. (2006). Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection. The Journal of Infectious Diseases, 193(1), 36-44.
Dhawan D, Mayer KH. Microbicides to Prevent HIV Transmission: Overcoming Obstacles to Chemical Barrier Protection. J Infect Dis. 2006 Jan 1;193(1):36-44. PubMed PMID: 16323129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection. AU - Dhawan,Darpun, AU - Mayer,Kenneth H, Y1 - 2005/11/17/ PY - 2005/07/11/received PY - 2005/10/27/accepted PY - 2005/12/3/pubmed PY - 2006/1/28/medline PY - 2005/12/3/entrez SP - 36 EP - 44 JF - The Journal of infectious diseases JO - J Infect Dis VL - 193 IS - 1 N2 - BACKGROUND: Microbicides are topical compounds that could prevent sexually transmitted infections. Several compounds have demonstrated activity both in vitro and in animal models, but none has been approved for use in humans. METHODS: A review of >100 recent publications from MEDLINE (through October 2005) and abstracts presented at recent conferences was undertaken to describe the current status of microbicide research and to delineate why microbicides are not yet available. RESULTS: More than 15 candidate microbicides are currently being studied in clinical trials. Their mechanisms of action include disruption of the viral membrane by surfactants, maintenance of an acidic vaginal pH, binding to the viral envelope to block receptor binding, and blocking of receptors; they may also be combined with antiretroviral drugs. The development of safe and effective microbicides has been delayed by limitations in understanding the biological processes of human immunodeficiency virus (HIV) transmission, difficulties in extrapolation from animal models, lack of established correlates of protection, and the need to enroll and follow large cohorts of high-risk participants for several years in order to demonstrate efficacy. CONCLUSIONS: Safe and effective topical microbicides are biologically plausible. Several trials that are under way may demonstrate the ability of microbicides to protect against transmission of HIV, but multiple challenges remain. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/16323129/Microbicides_to_prevent_HIV_transmission:_overcoming_obstacles_to_chemical_barrier_protection_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/499163 DB - PRIME DP - Unbound Medicine ER -