Muse

By DONALD G. McNEIL Jr.,   Published: July 26, 2010

VIENNA — The best AIDS-prevention news in years was released here last week at a world conference on the disease: a vaginal gel, called a microbicide, that can be used without a man knowing it, gave women a 39 percent chance of avoiding infection with the deadly virus.

Thirty-nine percent is, obviously, not perfect, though the women in the South African trial who used the gel most faithfully did better, achieving 54 percent protection.

After more than a dozen microbicide failures, it was a huge relief, and led to cheering and standing ovations for the researchers here.

“This is a field that’s known a lot of pain,” said Catherine Hankins, chief scientific adviser for Unaids, the United Nations’ AIDS-fighting agency.

There was general relief that the data was not as shaky as that of an AIDS vaccine trial released in September.

“There’s a certain feeling of ease and pleasure for me as a scientist that any way you slice the data, it’s statistically significant,” said Dr. Anthony S. Fauci, a top AIDS expert in the United States government, which paid most of the trial’s costs.

There was an unexpected bonus: the gel protected women even better against genital herpes. (The investigators were not sure why, but it contained tenofovir, an antiviral drug, and AIDS and herpes are both viral.)

Now experts are pondering the many questions raised by the news.

How much more testing will it need to win approval from drug regulators?

Would more than 1 percent tenofovir in the gel, or a two-drug mix, work better?

Can it be made cheaply enough for poor countries? (The gel costs 2 cents a dose, but the applicators are 40 cents because they are patented and were frequently redesigned to be more comfortable.)

READ FULL ARTICLE