Acta Pharm. 69 (2019) 297-319

full paper

Review

Clinical testing of antiretroviral drugs as future prevention against vaginal and rectal transmission of HIV infection – a review of currently available results

JAKUB VYSLOUŽIL, KATEŘINA KUBOVÁ, VERONIKA NOVÁKOVÁ TKADLEČKOVÁ and DAVID VETCHÝ

kubovak@vfu.cz

Department of Pharmaceutics, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic

Accepted January 31, 2019

Published online March 6, 2019

The original purpose of vaginally applied microbicides was to slow down the HIV epidemic among the population until an effective vaccination was developed. Nowadays, antiretrovirals applied in the form of gels or vaginal rings are considered most prominent in this field and are tested via vaginal or, rarely, rectal applications in numerous clinical studies (9 different antiretroviral drugs in 26 clinical studies, especially in Africa). Only tenofovir (1 % gel) and dapivirine (25 mg in vaginal ring) progressed into the phase III clinical testing. Their efficiency depended on the user´s strict adherence to the application regimen (for tenofovir 54 %, for dapivirine 61 % in participants over 25 years of age). Despite this, they are expected to be important and effective tools of preventive medicine in the near future. This review summarizes the results obtained during long-term clinical testing (2005–2018) of antiretroviral drugs against vaginal and rectal transmission of HIV infection.

Keywords: HIV prevention, microbicides, clinical trials, antiretroviral drugs