Antiretroviral gel wins R2.2m prize

South African husband and wife Salim and Quarraisha Abdool Karim led the epidemiological research trial.

South African husband and wife Salim and Quarraisha Abdool Karim led the epidemiological research trial.

Published Jan 31, 2014

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Johannesburg - It was a novel idea that didn’t garner much support.

It was an antiretroviral gel which would significantly reduce a woman’s risk of contracting HIV and genital herpes, but more importantly, one that would empower women who were unable to successfully negotiate mutual faithfulness or condom use with their partners, helping them to take control of their sexual health.

“You’re wasting your time,” the naysayers said.

“You’re going to cause drug resistance,” they charged.

But after gaining their proof of concept on the Centre for Aids Programme of Research in South Africa (Caprisa) 004 Tenofovir gel trial in 2010, and being announced as winners of the US Agency for International Development Science and Technology Pioneers Prize on Wednesday, the team of local and US researchers have less to debate with the naysayers these days.

The trial involved 889 women at an urban and rural site in KwaZulu-Natal. Overall, 98 women out of the 889 became 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 became infected in the placebo group.

The microbicide gel, containing one percent Tenofovir, an antiretroviral usually used for treatment of HIV, was 39 percent effective in preventing HIV infection in women. Furthermore, it also had a 51 percent effectiveness in preventing genital herpes infections.

“The results are anticipated in 2015, which could lead to licensure of the product,” Professor Quarraisha Abdool Karim told The Star on Thursday. “The government is already in the process of exploring how to produce the Tenofovir gel locally for public sector access.”

During the initial trial, all participants were provided with HIV risk-reduction counselling, condoms and treatment for sexually transmitted infections, and were tested for potential side effects and HIV infection.

The women – aged between 18 and 40 – were advised to use the gel up to 12 hours before sex and soon after having sex for a maximum of two doses, and used the gel for a minimum of one year and a maximum of two-and-a-half years.

Tenofovir works by preventing HIV from growing inside human cells.

The results from the trial indicated that, formulated as a topical gel and inserted into the female genital tract, it had promise for use in HIV and herpes prevention.

Co-principal investigator, Dr Salim Abdool Karim said: “We now have a prospect of looking at not just the gel, but more powerful formulations too… If we could make the gel available even for a few years, according to our mathematical model scenarios, we could prevent 2 million new (HIV) infections in the next 20 years.”

While the researchers say receiving the USAID award as well as the R2.2 million prize money is “humbling”, it will all be going to the thing they all love – science. - The Star

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