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Rectal microbicides

McGowan, Iana; Anton, Peterb

Current Opinion in HIV and AIDS: September 2008 - Volume 3 - Issue 5 - p 593–598
doi: 10.1097/COH.0b013e32830891cf
Microbicides: Edited by John Kaldor and Melissa Robbiani

Purpose of review This review will summarize the rationale for developing rectal microbicides and discuss recent developments in the preclinical and clinical evaluation of these products.

Recent findings It is clear that heterosexual women often engage in anal intercourse and that men who have sex with men can be found in both the developed and developing world. These observations have catalyzed the need to assess rectal safety of vaginal products and develop rectal specific microbicides. New approaches to the preclinical evaluation of rectal microbicides include the use of transgenic mice, nonhuman primate studies, and human colorectal explant systems. The design of phase I rectal safety studies is becoming increasingly sophisticated, including safety biomarkers to evaluate microbicide-induced immunotoxicity.

Summary There is growing acceptance that all vaginal microbicide candidates moving towards effectiveness studies should be evaluated for rectal safety. In addition, there is increasing awareness of the need to develop rectal specific microbicide formulations.

aUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

bDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA

Correspondence to Ian McGowan, MD, PhD, FRCP, University of Pittsburgh School of Medicine, 204 Craft Ave, Room B505, Pittsburgh, PA, 15213, USA Tel: +1 412 641 4710; fax: +1 412 641 6170; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.