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Can Vaginal gel beat vitamin D in preventing HIV infection?

Researchers from South Africa reported in the Jul 19, 2010 issue of Science that a vaginal gel may potentially be used to prevent HIV acquisition in women.

Karim Q.A. and colleagues from Centre for the AIDS Program of Research in South Africa (CAPRISA) conducted the CAPRISA 004 trial and found those who used the gel as instructed were 54 percent less likely to acquire HIV.

The trial was double-blind, randomized controlled involving 445 women who were advised to use the 1% tenofovir gel and 444 controls who were instructed to use placebo gel. All women were sexually active, HIV-uninfected and aged 18 to 40 in urban and rural KwaZulu-Natal South Africa.

The active ingredient Tenofovir is a nucleotide reverse transcriptase inhibitor.

During the 30-month follow-up, HIV serostatus, safety, sexual behavior, and gel and condom use were assessed monthly.

HIV incidence was found 5.6 per 100 women-years among those who used the tenofovir gel compared to 9.1 per 100 women-years among those who used the placebo gel. It suggests that using the vaginal gel may reduce the risk of HIV infection by 49 percent.

Among High adherers (more than 80 percent), HIV incidence was 54 percent lower in the tenofovir gel arm than that in the placebo gel arm.  But among low adherers (less than 50 percent), the HIV incidence was 28 percent lower in the tenofovir gel arm than that in the placebo arm.

Overall, the tenofovir gel cut HIV acquisition by about 39 percent.

The study gel did not increase the overall adverse event rates and the researchers did not see any changes in viral load and tenofovir resistance in HIV seroconverters.

The researchers suggest that the gel could potentially be used by women who are unable to have their partners to use condom or can have a one-on-one sexual relationship with their partners.

Food Consumer reported yesterday a study by  Mehta S. and colleagues from Harvard School of Public Health in Boston, Massachusetts suggesting that vitamin D could provide a better protection.

The study reported in the Oct 1 2009 issue of Journal of Infectious Diseases suggests that taking high doses of vitamin D may help reduce the risk of mother-to-child HIV transmission by 50 percent at 6 weeks of birth.

After 6 weeks, women with low vitamin D were 100 percent more likely to have mother-to-child HIV transmission.

In any case, women who want to use such an anti-HIV gel should receive a warning that using the vaginal gel does not offer 100 percent protection.

By Jimmy Downs