Thursday, February 01, 2007

Beware: AIDS microbicide makes you more vulnerable to HIV infection

An HIV prevention trial was halted in various Southern African countries and in India. The BBC reports that the investigators discovered that instead of reducing the risk of HIV infection the microbicide in question actually increased the risk. In other words, more participants (it being a microbicide, all women, of course) became infected in the active agent arm then in the placebo controlled arm of the trial.

There are several interesting questions with regard to this trial, none of which was flagged in the BBC news report:

  1. The women who participated in the trial, by definition were HIV negative when they enrolled. They became infected (almost certainly due to unsafe sex) during the trial. The question is whether these infections constitute a trial related injury that ought to be subject to compensation. Many of them might well have had a therapeutic misconception, that is they might have thought that the stuff they got in the clinic gave them some (a lot - complete?) protection against HIV.
  2. Indeed, one wonders whether these women will be provided with access to HAART when this could be clinically beneficial to them.
  3. Sexy as the idea of an HIV microbicide is, none of the trials undertaken so far have led anywhere. As a non-expert I wonder whether this is a dead-end type concept that is never going to work. You might say, reasonably so, that only further research will tell. The trouble is that we will only find out when women become infected during a trial. That's arguably a pretty high price to pay, even if the women were volunteers and even if they gave truly informed first person consent.

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