HIV and ID Observations

Big news from Vienna and Science, imminently:

The CAPRISA 004 trial assessed effectiveness and safety of a 1% vaginal gel formulation of tenofovir, a nucleotide reverse transcriptase inhibitor, for the prevention of HIV acquisition in women. A double-blind, randomized controlled trial was conducted comparing tenofovir gel (n = 445) with placebo gel (n = 444) in sexually active, HIV-uninfected 18- to 40-year-old women in urban and rural KwaZulu-Natal, South Africa … Tenofovir gel reduced HIV acquisition by an estimated 39% overall and by 54% in women with high gel adherence. No increase in the overall adverse event rates was observed. There were no changes in viral load and no tenofovir resistance in HIV seroconverters.

There have been a lot of false starts on this microbicide path, but this one is different — here an actual antiretroviral agent is being used, and, of course, this time it seems actually to work in preventing HIV transmission.

Logistics of drug development, patient acceptibility, applicable populations, cost, long term tolerability and resistance risk, etc. are all huge, but this is very good news regardless. 

Full scientific presentation is tomorrow (Tuesday), 1PM Vienna time; full published study available here.