Times of India
21 July 2010
By Kounteya Sinha
Avaginal gel can now protect women against HIV infection–an innovation that scientists believe could be the most crucial for reproductive health since the Pill.
On Tuesday, scientists announced at the International AIDS Conference in Vienna that they have successfully tested a gel containing antiretroviral drug Tenofovir, which is usually taken as a tablet by HIV patients. The drug can reduce a woman’s chances of contracting HIV from an infected partner by 50% if used 12 hours before and after having sex.
Interestingly, the gel had undergone a safety and acceptability trial on 100 women at the National AIDS Research Institute (NARI) in Pune in 2007. It can also reduce the risk of genital herpes by 51%.
Being hailed as a major breakthrough globally, the CAPRISA trial followed 900 HIV–negative, sexually active South African women in the 18 to 40 age group.
Two–and–a–half–years on, researchers found that the gel reduced chances of HIV infection by 50% after a year, and 39% after 30 months. The study revealed that women who used the drug consistently nearly 80% of the time before having sex would be 54% less prone to infection.
Health secretary K Sujatha Rao told TOI, “This is a major breakthrough, and will especially benefit India’s 300,000–strong sex worker community involved in multi–partner sex. It will also help women who usually do not have the power to insist on Condom use and fidelity, or to abandon partnerships that put them at high risk.”
NARI director Dr R S Paranjape said the gel underwent a safety and acceptability study in India as well. “The preparatory work for the CAPRISA trial was carried out here along with the Microbicide Trials Network. The overall safety profile of the gel was good and it was well accepted by women. Presently, it provides 40% protection. The scientific community will now look at increasing this percentage,” he said. Anti–HIV gel stops virus replication
With a HIV vaccine remaining elusive, scientists have for the past 20 years been looking for an effective microbicide–products like gels, films, rings or creams–that women could apply on their vagina to prevent HIV transmission. Finally, the breakthrough came in the form of a vaginal gel microbicide containing 1% Tenofovir.
Tenofovir gel is an advanced second–generation HIV–specific microbicide that neither tries to kill the AIDS virus nor blocks it from entering the body like its predecessors. Instead, it is designed to prevent the virus from replicating when it comes in contact with an uninfected T–cell. Naturally, the virus will fail to survive long enough to cause systemic infection.
K Chandramouli, Naco director–general, added, “At present, India has 2.7 million HIV patients. We also record 1.7 lakh fresh cases every year, nearly 40% of which are women. Such a microbicide, once ready for implementation in our programme, will greatly benefit women.”
Women, who constitute 50% of all new HIV cases globally, are also twice as likely as their male partners to contract HIV during unsafe sex. “Tenofovir gel could fill an important HIV prevention gap by empowering women who are unable to negotiate mutual faithfulness or Condom use with their male partners,” said study co–principal investigator Dr Quarraisha Abdool Karim.
The gel is undergoing a study to see the safety and efficacy of Tenofovir if used daily. Once over, drug regulatory authorities will determine if the gel is safe and effective for HIV prevention. It may take two years before the public can use it.
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