Study: Gel cuts women’s HiV in­fec­tions 50%

suc­cess rate may not be high enough for U.s. OK

Austin American-Statesman - - FRONT PAGE - By Mar­i­lynn Mar­chione

For the first time, a vagi­nal gel has proved ca­pa­ble of block­ing the AIDS virus: It cut in half a woman’s chances of get­ting HIV from an in­fected part­ner in a study in South Africa. Sci­en­tists called it a break­through in the long quest for a tool to help women whose part­ners won’t use con­doms.

The re­sults need to be con­firmed in an­other study, and that level of pro­tec­tion is prob­a­bly not enough to win ap­proval of the mi­cro­bi­cide gel in coun­tries such as the United States, re­searchers say. But they are op­ti­mistic it can be im­proved.

“We are giv­ing hope to women,” who ac­count for most new HIV in­fec­tions, said Michel Sidibe, ex­ec­u­tive di­rec­tor of the World Health Or­ga­ni­za­tion’s UNAIDS pro­gram. A gel could “help us break the tra­jec­tory of the AIDS epi­demic.”

And Dr. An­thony Fauci of the U.S. Na­tional In­sti­tutes of Health said, “It’s the first time we’ve ever seen any mi­cro­bi­cide give a pos­i­tive re­sult” that sci­en­tists agree is true ev­i­dence of pro­tec­tion.

The gel, spiked with the AIDS drug teno­fovir, cut the risk of HIV in­fec­tion 50 per­cent af­ter one year of use and 39 per­cent af­ter 2½ years, com­pared with a gel that con­tained no medicine.

To be li­censed in the U.S., a gel or

Con­tin­ued from A cream to pre­vent HIV in­fec­tion might need to be at least 80 per­cent ef­fec­tive, Fauci said.

That might be achieved by adding more teno­fovir or get­ting women to use it more con­sis­tently.

In the study, women used the gel only 60 per­cent of the time; those who used it more of­ten had higher rates of pro­tec­tion.

The gel also cut in half the chances of get­ting HSV-2, com­monly known as gen­i­tal her­pes. That’s im­por­tant be­cause other sex­u­ally spread dis­eases raise the risk of catch­ing HIV.

Coun­tries may come to dif­fer­ent de­ci­sions about whether a gel that of­fers this amount of pro­tec­tion should be li­censed. In South Africa, where one in three fe­males is in­fected with HIV by age 20, this gel could pre­vent 1.3 mil­lion in­fec­tions and 826,000 deaths over the next two decades, said Dr. Salim Ab­dool Karim, the South African re­searcher who led the study.

He will present re­sults of the study to­day at the In­ter- na­tional AIDS Con­fer­ence in Vi­enna.

The re­search was pub­lished on­line Mon­day by the jour­nal Sci­ence.

It’s the sec­ond big ad­vance in less than a year on the pre­ven­tion front.

Last fall, sci­en­tists re­ported that an ex­per­i­men­tal vac­cine cut the risk of HIV in­fec­tion about 30 per­cent. Re­search is un­der way to try to im­prove it.

If fur­ther study shows the gel to be safe and ef­fec­tive, the World Health Or­ga­ni­za­tion will work to speed ac­cess to it, Di­rec­tor-Gen­eral Mar­garet Chan said.

The gel is in limited sup­ply; if fur­ther study proves it is ef­fec­tive, a full-scale pro­duc­tion sys­tem would need to be geared up to make it.

“Ev­ery dol­lar we waste to­day puts a life at risk,” Clin­ton said.

Both he and Gates have started foun­da­tions that are ma­jor play­ers in the fight against HIV/AIDS.

“Our first task is to scale up pre­ven­tion ef­forts that are cheap, ef­fi­cient and easy to ap­ply,” Gates said.

He called for pur­su­ing male cir­cum­ci­sion, mak­ing health in­sti­tu­tions more ef­fi­cient and us­ing sim­pler HIV tests.

Clin­ton said or­ga­ni­za­tions waste too much money on send­ing Western ex­perts to af­fected coun­tries and on pro­duc­ing re­ports.

Ron­ald Zak

For­mer Pres­i­dent Bill Clin­ton, in Vi­enna on Mon­day, urged HIV/AIDS groups to de­liver ser­vices more ef­fi­ciently.

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