A history of microbicides and their current development pipeline

摘要

The idea for microbicides to prevent the transmission of sexually transmitted infections came from a discovery in the 1980s that over-the-counter spermicides showed antiviral activity in vitro. Since the advent of the HIV epidemic, microbicides have been tested as a possible tool for HIV prevention. The field of HIV microbicides has expanded to include five classes of mechanisms: surfactants, buffering agents, viral entry inhibitors, reverse transcriptase inhibitors and agents with an unknown mechanism. The most successful class to date has been the reverse transcriptase inhibitors, specifically tenofovir gel. Despite numerous setbacks in clinical studies (such as issues of adherence, interference with vaginal defenses and insufficient sample size to determine efficacy), the future of microbicide research is promising, with numerous agents in ongoing clinical studies.