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Microbicides: a new frontier in HIV prevention
1Center for Prevention Research, David Geffen School of Medicine at UCLA, Los Angeles, 10940 Wilshire Boulevard, Suite 1250, Los Angeles, CA 90025, USA. imcgowan@mednet.ucla.edu
Abstract:
Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections (STIs) including HIV-1. Despite more than two decades of HIV-1 vaccine research, there is still no efficacious HIV-1 vaccine, and the scientific community appears skeptical about the short or long-term feasibility of developing a vaccine that has the ability to induce sterilizing immunity against HIV-1. In this setting, microbicide research has gathered momentum. Currently, 16 candidate microbicides are in clinical development and five products are being evaluated in large-scale Phase 2B/3 effectiveness studies. Initial data from these trials will be available within the next 2-3 years, and it is feasible that there could be one or more licensed microbicides by the end of the decade. The first generation of surfactant microbicides had a non-specific mechanism of action. However, subsequent candidate microbicides have been developed to target specific steps in the process of viral transmission. The purpose of this article is to provide an overview of microbicide development and an update on the candidate pipeline.
Insights
Microbicides offer a promising strategy to prevent sexually transmitted infections (STIs), including HIV-1, as vaccine development faces challenges. Several candidate microbicides are in late-stage trials, with potential licensing by the decade
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- HIV-1 vaccine development has not yet yielded an effective solution, prompting research into alternative prevention methods.
- Microbicides are topical agents designed to prevent sexual transmission of infections like HIV-1.
- The scientific community is exploring microbicides as a viable strategy due to the limitations of HIV-1 vaccine development.
Purpose of the Study:
- To provide a comprehensive overview of the current landscape of microbicide development.
- To update on the pipeline of candidate microbicides undergoing clinical evaluation.
- To highlight the shift from non-specific to targeted microbicide mechanisms.
Main Methods:
- Review of ongoing clinical trials for candidate microbicides.
- Analysis of the mechanisms of action for different generations of microbicides.
- Assessment of the current status and future prospects of microbicide research.
Main Results:
- 16 candidate microbicides are in clinical development.
- Five products are undergoing large-scale Phase 2B/3 effectiveness studies.
- Initial trial data are expected within 2-3 years, with potential licensing by the end of the decade.
Conclusions:
- Microbicide research is gaining momentum as an alternative HIV-1 prevention strategy.
- The development pipeline includes both non-specific and targeted microbicides.
- Licensed microbicides may become available within the next decade, offering new tools for STI prevention.
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