Reasearchers’ HIV gel success claims receive mixed feelings

The pronouncements that researchers had achieved an important break-through in the fight against HIV and genital herpes with a vaginal gel that significantly reduces a woman’s risk of being infected with these viruses has been received with mixed feelings.

The results of the safety and effectiveness study of the an antiretroviral microbicide gel were reported by the Centre for The Aids Programme of Research in South Africa (CAPRISA ) at the just ended xviii international AIDS conference in Vienna , Austria.

The microbicide containing one per cent tenofovir –an antiretroviral drug widely used in the treatment of HIV –was found to be 38 per cent effective in reducing a woman’s chances of becoming infected with HIV during sex and 51 per cent effective in preventing genital herpes another viral infection afflicting women.

This follows a study which was under- taken on some women who participated in a clinical trial using the gel. According to the findings in Vienna should other studies of tenofovir gel confirm these results, then wide-spread use of the gel , at this stage of protection could prevent over half a million new infections in South-Africa alone over the next decade.

‘’Tenofovir gel could fill an important HIV prevention gap by empowering women who are unable to successfully negotiate mutual faithfulness or condom use with their male partners ,’’said Dr Abdool Karim , associate director of CAPRISA and Associate professor of Epidemiology at Columbia University .Dr Karim further stated that this technology has the potential to alter the course of HIV epidemic especially in Southern-Africa where young women bear the brunt of this devastating disease.

According to the findings tenofovir works by preventing HIV from growing inside human cells Taken in pill form tenofovir is a common component of various three drug cock-tails that are used to treat HIV infections. The new results now indicate that tenofovir formulated as a topical gel and inserted into the female genital tract also has great promise for use in HIV as well as herpes simplex virus type (HSV-2) prevention.

This is important for women who for social and cultural reasons are often unable to negotiate safer sex with their partners. Women make up the majority of new HIV infections around the globe, so the gel will empower this at-risk population with a safe and effective preventive tool.

Dr Margaret Kasaro from the Centre for Infectious Disease Control in Zambia (CIDRZ) says the success of the trials is a huge step in the effort to reduce HIV infection in women. She said this particular trial had specifically targeted the HIV virus unlike the others like PRO 2000 which were non specific to HIV.

“No matter how you look at it, this is a huge success, 39 percent might not look like much in figures but in terms of women’s protection it is huge. Bear in mind also that the research also showed that with consistent usage, the gel’s protection shot up to 54 percent.”
[pullquote]” In my view women should be encouraged to negotiate for condom use which is 99 per cent safe if properly used ,’’ Ms Chigona said[/pullquote]
But Liliane Chigona of Panos in welcoming the good news feels that people should also keep at the back of the minds that the gel is only 39 per cent safe which is still low.

” In my view women should be encouraged to negotiate for condom use which is 99 per cent safe if properly used ,’’ Ms Chigona said.
She further explained that when the gel goes on the market the issue of accessibility by an average woman is also questionable as well as the cost aspect of it.

‘’ We are not sure how easy these gels will be to accessed by the ordinary woman for protection because there is no doubt that she is the most vulnerable to the HIV infection much as it was been argued that the gels will empower most women as they can be applied prior to or during sex ,’’ Ms Chigona said.

Mr Chigona said much as the gel may be eventually commended for use after going through further studies accessibility still remains a thorny issue.

She said there is then need for a vigorous advocacy to be mounted especially in the area of accessibility as well as cost implications ,but in the mean-time people should not forget that the campaign for proper and consistent use of condoms should remain afloat.

The now promising findings of the CAPRISA 004 study is only a first step in determining if tenofovir gel is effective in preventing HIV and herpes infection ;additional studies are urgently needed to confirm and extend the findings of the Caprisa study.Important information still being anticipated from the Microbicide Trials Network (MTN) VOICE study which is currently assessing daily tenofovir gel as well as daily tenofovir and truvada tablets in women taking place in some African countries .

Dr Henry Gabelnick , executive director of the CONRAD said the company has given rights to manufacture this gel to the government of South Africa as the gel is very much needed among the women folk as rapidly as possible.

‘’The technology innovation Agency (TIA) is working closely with the South African government , CAPRISA and CONRAD to ensure that this important innovation makes an impact in preventing the spread of HIV –AIDS ,’’ said Dr Mamphela Ramphele of South- Africa.

Commenting on the findings , Ambassador Eric Goosby Global Aids Coordinator said the results of the CAPRISA trial provide new hope and direction for not only HIV prevention , but also broader efforts under the Global Health Initiative .

‘’We recognize that microbicide s will be a great asset to HIV prevention efforts and the U.S government is pleased to support this important research ,’’ he said.

The CAPRISA trial involved 889 women at high risk of HIV infection at an urban and a rural site in Kwazulu Natal South Africa .Overall 98 women out of the 889 become HIV positive during the trial with 38 in the tenofovir gel group and 60 in the placebo gel group.

Out of the 434 women who tested negative for herpes at the start of the trial , 29 became infected in the tenofovir group and 58 become infected in the placebo group.
[ Times of Zambia ]