Microbicides 2004 Conference held in London

Over 700 people from over 50 countries gathered in London for Microbicides 2004 (March 28-31), the third bi-annual conference devoted to the search for a cream or gel that could be applied vaginally or rectally to block HIV infection. The field has grown significantly over the past four years and as many as six large-scale efficacy trials of microbicides are scheduled to begin in 2004. There are also over 60 candidates in various stages of pre-clinical and clinical development (see Primer).

Scientific presentations at the meeting highlighted challenges confronting the field. Several speakers focused on recent insights into how HIV infection occurs during sexual transmission. HIV can infect several different types of cells found in the “mucosal” surfaces of the vagina, cervix and rectum. This means that the virus can take several different pathways into the body and that an effective microbicide will probably have to block infection of a number of different types of cells.

Other presentations explored ethical issues surrounding microbicide trials, many of which also face AIDS vaccine trials. Challenges include how to ensure that trial volunteers who become infected with HIV receive high quality treatment and care; and when and how to involve the male partners of women volunteers. (A full report on the state of microbicide research will appear in an upcoming issue of VAX).