HIV Prevention Research Unit, Medical Research Council, Durban, South Africa.
Curr Opin HIV AIDS. 2010 Jul;5(4):316-21. doi: 10.1097/COH.0b013e32833a9f66.
Microbicide research has been in the forefront of scientific literature in recent months. Results of large-scale clinical trials have been announced with resultant investigations into the factors that may have contributed to the disappointing outcomes of the most promising candidates. This review takes into consideration clinical, basic scientific and behavioural research published on microbicides in the past 12-18 months.
Two trials testing PRO 2000, a sulphated polymer, suggested that it has no effect on HIV. Basic science research revealed several facts such as the loss of antiviral activity of microbicides in the presence of seminal plasma. Methodological models suggested that dilution factors might impact on measures of efficacy. Advancement into safety testing of highly specific antiretroviral products such as tenofovir and UC781 for both rectal and vaginal use shows promise. Development of drug delivery systems such as intravaginal rings may alleviate some of the adherence challenges faced when using coitally dependant products.
In the recent past, microbicide research has had disappointing outcomes. However, it has also provided a better understanding of factors that may reduce effectiveness of promising products, enabling the field to be better equipped to select and test new products.
综述目的：最近几个月，杀微生物剂研究一直是科学文献的前沿领域。已公布了大型临床试验的结果，随后对可能导致最有希望的候选药物令人失望的结果的因素进行了调查。本综述考虑了过去 12-18 个月在杀微生物剂方面发表的临床、基础科学和行为研究。
最近的发现：两项测试 PRO 2000（一种硫酸化聚合物）的试验表明，它对 HIV 没有影响。基础科学研究揭示了一些事实，例如在存在精液的情况下，杀微生物剂的抗病毒活性丧失。方法模型表明，稀释因素可能会影响疗效的衡量标准。在直肠和阴道使用方面，高度特异性抗逆转录病毒产品（如替诺福韦和 UC781）的安全性测试取得了进展，这表明有希望。开发药物输送系统，如阴道环，可能会缓解在使用与性行为相关的产品时面临的一些依从性挑战。
总结：在最近的过去，杀微生物剂研究的结果令人失望。然而，它也更好地了解了可能降低有前途产品效果的因素，使该领域能够更好地选择和测试新产品。
