[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/6384\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EHIV prevented from entering the body\u003C\/h2\u003E\u003Cp\u003EAlthough oral administration of these drugs has in recent years downgraded HIV from a death sentence to a chronic medical condition, Professor Charles Lacey at the University of York in the UK still describes HIV as one of the deadliest pandemics the world has ever seen.\u003Cdiv class=\u0022tw-text-center tw-bg-bluelightest tw-p-12 tw-my-12 tw--mx-16\u0022\u003E\n \u003Ch3 class=\u0022tw-font-sans tw-font-bold tw-text-blue tw-uppercase tw-text-lg tw-mb-8\u0022\u003EThe Issue\u003C\/h3\u003E\n \u003Cspan class=\u0022tw-inline-block tw-w-1\/6 tw-h-1 tw-bg-blue tw-mb-8\u0022\u003E\u003C\/span\u003E\n \u003Cp\u003EOne in every 200 people around the world currently lives with HIV and over one million new infections are recorded each year.\u003C\/p\u003E\u003Cp\u003EAlthough advances in antiretroviral drugs can now contain the damage that the virus does to the human immune system, there is still no cure for the condition. As treatment costs escalate and the virus develops resistances to existing drugs, researchers are racing to halt its spread.\u003C\/p\u003E\u003Cp\u003EMicrobicides, which use antiretroviral drugs topically, have shown promise at preventing sexual transmission of the disease. Whether the protection that they offer can be boosted to the safety levels of condoms now remains to be seen.\u003C\/p\u003E\n\u003C\/div\u003E\n\u003C\/p\u003E\u003Cp\u003E\u2018The virus cannot yet be cured and it continues to claim thousands of lives each day,\u2019 he said. \u2018We have to work out ways to slow down and then stop new cases.\u2019\u003C\/p\u003E\u003Cp\u003EIn 2010, the \u003Ca href=\u0022http:\/\/www.caprisa.org\/\u0022 target=\u0022_blank\u0022\u003ECentre for the Aids Programme of Research in South Africa\u003C\/a\u003E showed that a single antiretroviral drug delivered to the vagina or rectum during sexual intercourse could reduce HIV infection rates by close to 40 %.\u003C\/p\u003E\u003Cp\u003EOver the past five years, Prof. Lacey has taken part in the EU-funded CHAARM project to build on this and try to reduce infection rates even further with several antiretroviral drugs combined into a single, easy-to-use delivery method, such as a gel or a vaginal ring. This new form of prevention could boost the appeal and efficacy of microbidices among vulnerable communities.\u003C\/p\u003E\u003Cp\u003EAs coordinator of the project, Professor Charles Kelly at King\u2019s College London in the UK explained that rectal and vaginal microbicides contain the same drugs that are used in systemic HIV treatments, but releasing them under more favourable circumstances could turn the tide in the struggle against HIV.\u003C\/p\u003E\u003Cp\u003E\u2018The difference is that by applying the drugs topically we can deliver higher doses of them with fewer side effects,\u2019 he said. \u2018Also, microbicides make it possible to hit the virus when it is vulnerable.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EStopped at the gate\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003ETackling the process of infection erodes one of HIV\u2019s greatest assets. In contrast to systemic treatments that have to combat generations of viruses that are already replicating inside the body, a microbicide limits to a single shot the chances of the virus getting past its defences.\u003C\/p\u003E\u003Cp\u003E\u003Cspan style=\u0022font-size: 13.008px; line-height: 1.538em;\u0022\u003E\u2018If HIV is stopped at the gate, that\u2019s the end of the infection,\u2019 said Prof. Kelly.\u003C\/span\u003E\u003C\/p\u003E\u003Cp\u003ECondoms remain the gold standard in terms of HIV prevention, but communities among which their use is inconsistent urgently need alternatives.\u003C\/p\u003E\u003Cp\u003EGus Cairns, from the European AIDS Treatment Group in Brussels, Belgium, said that discreet prevention methods such as microbicide gels and vaginal rings could offer millions of young women in lower income countries better chances to protect themselves against HIV infection.\u003C\/p\u003E\u003Cp\u003E\u2018The virus is spreading in many countries where gender equality is not a given and where the stigma attached to HIV is severe,\u2019 said Cairns. \u2018Many women cannot challenge their partners by asking them to wear a condom.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cfigure role=\u0022group\u0022 class=\u0022@aligncenter@\u0022\u003E\n\u003Cimg alt=\u0022Though the number of new HIV infections has dropped since the mid-1990s, there were still more new cases in 2014 than in 1990.\u0022 height=\u0022585\u0022 src=\u0022\/research-and-innovation\/sites\/default\/files\/hm\/HIVinfections-HORIZON-01.png\u0022 title=\u0022Though the number of new HIV infections has dropped since the mid-1990s, there were still more new cases in 2014 than in 1990.\u0022 width=\u0022586\u0022\u003E\n\u003Cfigcaption class=\u0022tw-italic tw-mb-4\u0022\u003EThough the number of new HIV infections has dropped since the mid-1990s, there were still more new cases in 2014 than in 1990.\u003C\/figcaption\u003E\n\u003C\/figure\u003E\n\u003C\/p\u003E\u003Cp\u003EIf researchers can make microbicides that are both safe to use and accessible, these women could take charge of their own sexual health.\u003C\/p\u003E\u003Cp\u003EThe work has also led to new discoveries about how drugs administered through the vagina enter the body and how to combine different drugs in a single gel.\u003C\/p\u003E\u003Cp\u003EWhereas the proteins that transport drugs inside and out of cells of the digestive and circulatory system are well documented, little was known about those in the vagina before the CHAARM project began.\u003C\/p\u003E\u003Cp\u003E\u2018We found, for instance, a protein that naturally pumped the drugs that we were testing out of vaginal cells,\u2019 said Prof. Kelly.\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u2018This is step toward a larger challenge of achieving total body control and is applicable to many diseases.\u2019\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProf. Steve Bloom, Imperial College London, UK\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003ETo complicate matters further, the genetic adaptability of HIV limits the therapeutic effect of any single drug. Medical practitioners work around this challenge by administering different kinds of antiretroviral drugs at the same time.\u003C\/p\u003E\u003Cp\u003EFollowing the same strategy with microbicides means combining active chemical compounds while keeping their pharmaceutical effects separate. According to Prof. Kelly, this is no minor undertaking.\u003C\/p\u003E\u003Cp\u003E\u2018The two first antiretroviral drugs that we tested, Darunavir and Dapivirine, initially reacted in undesirable ways with each other,\u2019 said Prof. Kelly. \u2018They also responded in different ways to the medium within which we were formulating them.\u2019\u003C\/p\u003E\u003Cp\u003ERather than compromise on the active ingredients, CHAARM enlisted the expertise of Particle Sciences, a biotech firm in Bethlehem, Pennsylvania, in the US. The company developed a series of physicochemical tricks to combine the two drugs harmoniously.\u003C\/p\u003E\u003Cp\u003EThese achievements were broadened to different kinds of antiretroviral drugs in the recently finished MOTIF project, also led by Prof. Kelly, which explored how optimised formulations and dosing could spread microbicides over all internal surfaces in the vagina and rectum, and into the human cells that need protection.\u003C\/p\u003E\u003Cp\u003EBefore the CHAARM project came to an end, Prof. Lacey oversaw a trial of the gel, which proved that a microbicide combining Darunavir and Dapivirine was safe for use in humans.\u003C\/p\u003E\u003Cp\u003ELaboratory tests on graft tissue and in animal models suggest that the formulation could reduce HIV infection rates further than the single drug microbicides tested to date, but Prof. Lacey remains cautious on the matter.\u003C\/p\u003E\u003Cp\u003E\u2018When you translate a medical intervention from cells in a test tube, to animal models, to real life human populations, you always get different numerical read outs of protection,\u2019 he said. \u2018Only clinical trials on human patients can now reveal the full impact that microbicides will have on HIV.\u2019\u003C\/p\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n \u003Cdiv id=\u0022edit-body-content--description\u0022 class=\u0022ecl-help-block description\u0022\u003E\n Please copy the above code and embed it onto your website to republish.\n \u003C\/div\u003E\n \u003C\/div\u003E\n\u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-bs-vdwrt6xqxrwjc5yl4rb-e00n7bqiw8cvlnbvg50\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-bs_vdWRt6XQxRwjC5yL4rb-_e00n7bQiW8cVlnbvG50\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-modal-form-example-modal-form\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022modal_form_example_modal_form\u0022 \/\u003E\n\u003C\/form\u003E\n\u003C\/div\u003E","dialogOptions":{"width":"800","modal":true,"title":"Republish this content"}}]