针对艾滋病毒局部杀微生物剂研究进展.docVIP

针对艾滋病毒局部杀微生物剂研究进展 　　摘 要高效抗逆转录病毒疗法（HAART）的推广应用使HIV/AIDS的治疗和控制获得了巨大的成功，但至今在艾滋病毒（HIV）感染的预防上却驻足不前，HIV疫苗研究遇到种种困难。在HIV感染者中，女性约占50%，其中绝大多数是通过性途径传播而患病的。本文综述近几年在针对HIV的局部杀微生物剂方面的研究进展：Ⅱ期临床多中心试验结果显示，0.5% PRO2000能使HIV的感染率下降约30%；感染动物试验显示，含1%替诺福韦酯的阴道凝胶剂在预防猴免疫缺陷病毒（SIV）感染方面效果显著。双盲、随机、对照临床试验也证实，含1%替诺福韦酯阴道凝胶剂可使妇女减少39%的HIV感染风险，对高依从性妇女则可将HIV感染风险降低54%，且不良反应发生率未见增加，未出现对替诺福韦酯的耐药。可以预计，针对HIV的局部杀微生物剂有望成为人类阻遏HIV肆虐的又一道有效防线。 　　关键词艾滋病毒 杀微生物剂 　　中图分类号：R978.7 文献标示码：A 文章编号：1006-1533(2011)11-0535-04 　　Progress in the research of topical microbicides against HIV 　　SHAO Jia-sheng1*，LU Hong-zhou1，2，3，SHEN Yin-zhong1，ZHANG Yong-xin2 　　（1. Shanghai Public Health Clinical Center，Fudan University，Shanghai，201508； 　　2. Huashan Hospital，Fudan University，Shanghai，200040； 　　3. Department of Internal Medicine of Shanghai Medicial College，Fudan University，Shanghai，200032） 　　AbstractThe stunning accomplishment has been achieved for the control of HIV/AIDS since highly active antiretroviral therapy (HAART) was used in clinic，but little progress was made in the field of the prevention of HIV infection. As we all known，there are lots of setbacks in the development of HIV vaccine which made some scientists frustrated. Women comprise almost 50% of the population of people living with HIV and the majority of them contracted the virus through sexual transmission in monogamous relationships，especially in the undeveloped settings. A multi-center clinical trial indicated 30% effectiveness with the 0.5% PRO2000 gel，while a study in macaque monkeys showed that a vaginal gel containing 1% tenofovir-alone or in combination with 5% emtricitabine (FTC) was highly effective in preventing infection from SHIV. Tenofovir gel reduced HIV acquisition by an estimated 39% overall，and by 54% in women with high gel adherence，which was showed in a double-blind，randomized controlled trial and no adverse effects and drug resistance were observed. It is promising that topical microbicides againstt HIV can be another defense line for s