Virginia School's Research on HIV Continues After Drug Setback

When international Phase III trials of the vaginal microbicide candidate cellulose sulfate began in 2005, it was the lead product in the portfolio at Contraceptive Research and Development (CONRAD), an Eastern Virginia Medical School program. More than 1,300 women participated in the controlled study, which was halted in January 2007 after preliminary results found the compound could increase HIV risk.

"Women were using the compound and were protected while using the compound," explained Dr. Gustavo F. Doncel, a lead CONRAD researcher. "At the same time, they were attracting cells that were infectable cells. Stop using these compounds and they [still] have these cells that are more receptive of HIV."

Despite the setback, the Bill & Melinda Gates Foundation awarded CONRAD $28.5 million for its microbicide research just months after the trial stopped. In September 2008, the US Agency for International Development followed with a five-year, $100 million grant.

"Depending on who you talk to, it was either the worst thing that ever happened in the world, or for those of us in the microbicide field, it was something we expect" of experimental compounds, said Jim A. Turpin, a scientist with the National Institutes of Allergy and Infectious Diseases.

Ideally, a microbicide would destroy the virus before it gets into tissue, Doncel said, but such compounds tend to be too strong for vaginal use. The study gel was designed to block HIV.

"The microbicide field and the vaccine field, both I think, underestimated this virus," said Doncel.

"This is a very common scenario in new drug development," said Anna Forbes, deputy director of the Global Campaign for Microbicides. "It's really crucial for women to have a way to protect themselves from HIV that is in our own hands, that we can control ourselves."

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