{"id":17406,"date":"2017-06-02T16:51:31","date_gmt":"2017-06-02T23:51:31","guid":{"rendered":"https:\/\/sop.washington.edu\/?p=17406"},"modified":"2018-08-24T10:16:46","modified_gmt":"2018-08-24T17:16:46","slug":"team-learns-why-hiv-prevention-drug-is-not-as-effective-in-some-women","status":"publish","type":"post","link":"https:\/\/staff.washington.edu\/twentzel\/wordpress\/team-learns-why-hiv-prevention-drug-is-not-as-effective-in-some-women\/","title":{"rendered":"Pharmaceutics lab team learns why HIV prevention drug is not as effective in some women"},"content":{"rendered":"

Klatt lab team\u2019s findings published in Science<\/em> offer solutions to increase efficacy<\/h4>\n
\"UW
UW Pharmaceutics Klatt Lab’s graduate student Ryan Cheu, Associate Professor Nichole Klatt, and post-doc Alex Zevin <\/figcaption><\/figure>\n

More than 1 million women are infected with HIV annually, and the majority of these new infections occur in young women in sub-Saharan Africa, with South Africa having among the highest incidence rates. Tenofovir is an antiretroviral drug that is used to prevent HIV infection (pre-exposure prophylaxis, \u201cPrEP\u201d). In clinical trials, tenofovir was effective for men, efficacy was highly variable in women.<\/p>\n

In an article<\/a> published in Science<\/em>, UW School of Pharmacy Associate Professor of Pharmaceutics Nichole Klatt, along with UW graduate student Ryan Cheu, post-doc Alex Zevin, and Adam Burgener\u2019s lab at the Public Health Agency of Canada found that tenofovir used as a topical vaginal gel for HIV prevention was more efficacious in women with healthy vaginal bacteria than bacteria associated with vaginosis, such as Gardnerella vaginosis. <\/em>Furthermore, the team went on to determine that the reason tenofovir is less effective in women with G. vaginalis<\/em> is because this bacteria can metabolize, or break down, the drug.<\/p>\n

Their findings suggest that women with non\u2013Lactobacillus<\/em>-dominant vaginal bacteria may be more sensitive to the timing of gel application and adherence, whereas bacterial communities with Lactobacillus<\/em> dominance may facilitate an environment more conducive to the topical PrEP efficacy.<\/p>\n

The international team studied 688 women and investigated whether vaginal microbiota modulated tenofovir gel PrEP efficacy. It turned out that tenofovir reduced HIV infection by a 61% in women who were Lactobacillus-<\/em>dominant\u2014a staggering three-fold difference over women whose systems were non-Lactobacillus <\/em>dominant. In non-Lactobacillus<\/em> dominant systems, Tenofovir only reduced HIV incidency by 18%. Both groups had similar adherence to applying the gel.<\/p>\n

The rapid depletion of tenofovir by G. vaginalis<\/em> and other bacterial vaginosis (BV)-associated anaerobic bacteria by metabolism provides a biological mechanism likely contributing to a multifactorial process, including increased vaginal inflammation and adherence, leading to varying levels of HIV prevention efficacy observed across topical microbicide trials. Their data indicate that G. vaginalis<\/em> is capable of decreasing the active drug by metabolizing tenofovir before drug uptake by target cells.<\/p>\n

These findings provide evidence about the importance of vaginal microbial communities on prevention efficacy, which could help improve this HIV specific prevention strategy for women.<\/p>\n

Because Lactobacillus dominance corresponds with a relatively low vaginal pH, typically below\u00a04.5, vaginal pH testing may be a pragmatic approach to identify women most likely to benefit from topical tenofovir-containing microbicides and potentially other prevention strategies.<\/p>\n

However, current treatment strategies for BV may not be sufficiently efficacious and better strategies that can both deplete anaerobic bacteria and support recolonization with Lactobacillus<\/em> may be required. If validated in other trials, this could be a compelling reason for integrating topical microbicide implementation with sexual and reproductive health services so that vaginal health becomes an integral component of HIV prevention approaches.<\/p>\n

Related: A microbiome variable in the HIV-prevention equation: Vaginal microbes thwart an antiretroviral microbicide<\/a><\/p>\n

Associated Press Coverage:\u00a0Women’s bacteria thwarted attempt at anti-HIV vaginal gel<\/a><\/p>\n

To study with researchers like Dr. Klatt, click on the links for\u00a0more information about our\u00a0Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.<\/a><\/p>\n

Link to Pharmaceutics archived news<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Klatt lab team\u2019s findings published in Science offer solutions to increase efficacy More than 1 million women are infected with HIV annually, and the majority of these new infections occur in young women in sub-Saharan…<\/p>\n","protected":false},"author":3,"featured_media":16712,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[33,31],"tags":[],"class_list":["post-17406","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pceut-news","category-sop-news"],"yoast_head":"\nPharmaceutics lab team learns why HIV prevention drug is not as effective in some women - School of Pharmacy<\/title>\n<meta name=\"description\" content=\"Klatt lab team\u2019s findings published in Science offer solutions to increase 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