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Chapter 15 : Microbicides: Molecular Strategies for Prevention of Sexually Transmitted Viral Disease

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Abstract:

This chapter provides an overview on molecular strategies for prevention of sexually transmitted viral disease. The chapter focuses on the perceived need, basic research challenges, and scientific grounds for confidence in the development of anti-human immunodeficiency virus (HIV) type 1 (HIV-1) microbicides with emphasis on viral/pathogen synergies and mucosal factors of susceptibility. Synergistic mechanisms underlying the phenomenon of "amplified transmission" are discussed in the chapter. Mathematical modeling predicts that even a partial protection would substantially relieve the burden of the HIV pandemic. Nevertheless, because of the viral diversity and the complexity and redundancy of the viral mucosal penetration routes, it is unlikely that a single microbicide or multiple microbicides inhibiting acquisition via a single target would prove to be fully efficient. The major mechanisms of action targeted by microbicides, so far, are degrading or neutralizing the virus before it reaches its target cells, blocking the viral entry and intercellular passage, as well as attacking the intra-cellular steps of the viral cycle, mainly the reverse transcription and viral integration processes. The mechanism of action of the antiretroviral drugs nucleoside and non-nucleoside RT inhibitors (NRTIs and NNRTIs) is discussed in detail. The development of prevention strategies and tools to encompass the global diversity of HIV-1, to be holistically compatible with the wide range of age and multicultural and socioeconomic backgrounds, is a colossal international undertaking that has mobilized scientists, advocates, philanthropists, and policy makers around the world.

Citation: Fichorova R. 2009. Microbicides: Molecular Strategies for Prevention of Sexually Transmitted Viral Disease, p 265-282. In LaFemina, Ph. D. R (ed), Antiviral Research. ASM Press, Washington, DC. doi: 10.1128/9781555815493.ch15
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