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Font Resize By Donald G. McNeil Jr. New York Times Posted: 10/20/2011 10:56:30 PM PDTUpdated: 10/20/2011 11:31:25 PM PDT A vaginal gel that sharply reduces a woman's risk of infection with HIV -- the virus that causes AIDS -- is even more effective against genital herpes, a much more common risk for young women in the United States, a new study has found.
The study, by researchers from the National Institutes of Health, Gilead Sciences and universities in Belgium and Italy, suggests that the microbicide gel, which was originally developed to fight AIDS in Africa, could lower the incidence of herpes in many women.
"This could be incredibly helpful," said Dr. Jeanne Marrazzo, a herpes expert from the University of Washington's medical school. "Protection that a woman can control is the holy grail in this field. It's hard for me to believe that something that protects against both HIV and herpes wouldn't be appealing to a lot of young American women."
An executive at Gilead, the company that makes tenofovir, the anti-AIDS drug that is the gel's active ingredient, said the company was debating whether to spend the millions of dollars needed to get the gel approved for the U.S. market. Even if the company pressed ahead immediately, "it would be three to four years before we were ready to submit data" to the Food and Drug Administration, said Norbert W. Bischofberger, Gilead's chief scientific officer.
Genital herpes is far more common than AIDS. The World Health Organization estimates that 20 percent of all sexually active adults have genital herpes. In
the United States, the Centers for Disease Control and Prevention estimates that 21 percent of all sexually active women have it, including 16 percent of all white women and 48 percent of all black women.While not fatal, the infection can be very painful, ruining sexual pleasure. The blisters it causes, which resemble the cold sores caused on the lips by a related virus, can also be an entryway for more dangerous pathogens, including HIV and syphilis.
It can be transmitted when neither partner has sores, and even using a condom is effective in preventing infection only half the time, said Dr. Anna Wald, a herpes specialist at the University of Washington's school of public health, because -- unlike HIV -- it can be transmitted by skin-to-skin contact, not just in semen or vaginal fluid.
And although it can often be controlled with another drug, acyclovir, herpes is not curable.
The new study, published online by Cell Host and Microbes this week, explains the surprise result of a much-heralded 2010 clinical trial done in South Africa.
That trial, run by Caprisa, an AIDS research center in Durban, showed for the first time that tenofovir gel protected women against HIV. But it also showed that the roughly 450 women in the survey who did not have herpes were even better protected against it than they were against HIV.
Overall, the gel reduced HIV infections by 39 percent. That announcement was greeted with a standing ovation by scientists at the international AIDS Conference in Vienna last year because it was the first weapon that women at risk of HIV infection could use without a man's knowledge.
In an unexpected bonus, the researchers also noted that it reduced herpes by 51 percent.
The new study, involving laboratory experiments, was done to explain why the trial worked, said Dr. Salim Abdool Karim, a professor of epidemiology at the University of KwaZulu-Natal in South Africa and Columbia University and one of the Caprisa trial leaders.
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