Prevention

Microbicides : Microbicides, the prime focus of our prevention therapy research, are a cornerstone of the global strategy to combat HIV transmission.

What Are Microbicides?

Microbicides are a chemical substance, typically a lubricant or a gel. They contain drugs which can significantly prevent or reduce sexually transmitted infections, including HIV, when applied locally to the vagina or rectum.

Microbicides function by reducing the risk of infection per sexual act.

They are the first new preventions against HIV developed since condoms and other behavioral modifications. The rate of new infections suggests that these “liquid condoms” would fill an important prevention gap for men and women who cannot successfully negotiate mutual monogamy or male condom use.

CPR is among the few groups worldwide currently developing these innovative therapies for the rectal area. To date, the focus of microbicide studies has been on vaginal agents, with limited research on rectal formulations. Because the vagina and the rectum differ greatly in ecology and structure, they will require different product formulations. In addition, the rectum is far more vulnerable to HIV transmission than the vagina, and anal intercourse is between 10 and 200 times more likely to result in transmission of HIV than vaginal intercourse.

Treatments

Anti-Inflammatories : HIV introduces an acute inflammatory state in the gastrointestinal lining years before it leads to immune deficiency. CPR is investigating anti-inflammatory components, both for patients already taking anti-retroviral therapy (ART) and with volunteers not presently on ART. Although not anti-viral, these anti-inflammatory agents would reduce the inflammatory milieu of the gastrointestinal lining.

Probiotics : Despite the effectiveness of ART, HIV-associated diarrhea remains a significant symptom. CPR is studying the possibility that this may result from imbalances in the intestinal flora. Microbial food supplements, or probiotics, are being considered as a supplement that could improve intestinal microbial balance and decrease symptoms of diarrhea.

Vaccines

CPR maintains an aggressive role in HIV vaccine research. We are one of the leaders in analyzing whether immune responses actually occur where and when the virus first enters the body, and how vaccines may prime the mucosal surfaces to be activated against HIV during exposure. We recognize that an acceptable HIV vaccine is many years away; a combined approach of vaccines and microbicides is the only tenable scientific response to prevent further spread of HIV.

Research Achievements of Note

CPR’s scientific insights over the last decade include:

• identifying the gastrointestinal tract as a major reservoir for the HIV virus, which harbors almost twice as much as a person’s blood;
• clarifying that the virus stored in the intestine does not decay or reduce over time, as is the case with blood-related reservoirs;
• confirming the fact that using anti-retroviral therapy alone is not sufficient to eradicate HIV from the body: even with patients who use fully suppressive medications, persistent and steady levels of HIV are evident in intestinal tissue as well as in the blood;
• developing novel techniques for measuring the immune response in mucosal tissue;
• creating models for testing products on human tissue after it has been removed from the donor (explants).