Microbicidas para la prevención de infecciones de transmisión sexual: estado actual y estrategias para la evaluación preclínica de nuevos candidatos / Microbicides for preventing sexually transmitted infections: current status and strategies for preclinical evaluation of new candidates

Los microbicidas constituyen una nueva herramienta, todavía en proceso de investigación, que podrían ayudar en la prevención de la infección por los virus de la inmunodeficiencia humana (Human immunodeficiency virus: HIV) y de otras infecciones de transmisión sexual (ITS). Una serie de evidencias ha demostrado que la complejidad de la transmisión sexual de patógenos virales requiere de la identificación de compuestos capaces de bloquear los eventos tempranos del ciclo de infección viral. En este manuscrito hacemos una revisión exhaustiva de las diferentes estrategias que se han estudiado o se están considerando para prevenir ITS mediante el uso de microbicidas, haciendo particular énfasis en aquellos con el potencial de bloquear la infección por el HIV. También se revisa el proceso complejo de evaluación preclínica que se requiere para llegar a estudios en humanos y se concluye con un breve análisis de las estrategias que podrían formar parte del futuro inmediato en la investigación de microbicidas

Microbicides are a new tool, still under investigation, which could help prevent infection by the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Increasing evidence shows that the complexity of sexual transmission of viral pathogens requires the identification of compounds able to block the early events during the cycle of viral infection. In this manuscript we provide a comprehensive review of the different microbicide strategies that have been studied or are currently being considered for STI prevention, particularly emphasizing those having the potential to block HIV infection. The manuscript also reviews the complex process that is required to conduct future clinical studies in humans and concludes with a brief discussion of the strategies that could be part of the immediate future in microbicide research

Microbicides: a new hope for HIV prevention.

Human immunodeficiency virus (HIV), causative agent of acquired immunodeficiency syndrome (AIDS), is a global health concern. To control its transmission, safe sex has been proposed as one of the strategies. Microbicides- intravaginal/intrarectal topical formulations of anti-HIV agents have also been proposed to prevent HIV transmission. Microbicides would provide protection by directly inactivating HIV or preventing the attachment, entry or replication of HIV in susceptible target cells as well as their dissemination from target cells present in semen or the host cells lining the vaginal/rectal wall to other migratory cells. Microbicides must be safe, effective following vaginal or rectal administration, and should cause minimal or no genital symptoms or inflammations following long-term repeated usage. However, a safe and efficacious anti-HIV microbicide is not yet available despite the fact that more than 60 candidate agents have been identified to have in vitro activity against HIV, several of which have advanced to clinical testing. Nonetheless, proof-of-concept of microbicides has been established based on the results of recent CAPRISA 004 clinical trials. In this article, the trends and challenges in the development of effective and safe microbicides to combat HIV transmission are reviewed.

Microbicides in India-present and future.

India continues to wage a battle against the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic. Despite an array of preventive and control efforts directed against the disease, it continues to finds its way from the high risk groups to the general population. Women are more vulnerable to HIV/AIDS because of biological as well as socio-cultural factors. Microbicides appear to provide an attractive option as a means of protection to be used by women. At present, microbicide trials are in study phases I and II in India. The development of an ideal microbicide candidate which would be effective and confirms to user satisfaction poses a major challenge to researchers.

Acceptability of vaginal microbicides among female sex workers in urban Beijing,China / 中华流行病学杂志

Objective To explore the aaitudes and willingness towards vaginal microbicides use among female sex workers(FSWs)for HIV/AIDS and sexually transmitted infection(STI)prevention jn an urban district of Beiiing,China,as well as its related factors.Methods A cross-sectional study using convenience sampling Was conducted.A total of 54 FSWs were recruited from Shijingshan District in urban Beijing.Main outcome vailables were measured by microbicide acceptability score with questionnaire,including high-risk sexual behaviors,self-reported condom use,self-reported HIV/STI history and perception on the risk of HIV/STI.Results Mean score of microbicide acceptability in FSWs was 2.73(ranging 1 to 4).Acceptability score varied by the type of their sex panner(P=0.049),experience of HIV testing(P=0.037)and concems about contracting STI(P=0.042).Willingness to use and covert use of microbicides in FSWS varied significantly with their sex partners(P=0.001).Conclusion FSWs in Shijingshan district might have a positive response to vaginal microbicides use across all hypothetical characteristics in general.Further study iS needed for comprehensive understanding of contextual factors related to it.