Microbicide delivery: formulation technologies and strategies

Purpose of review: The aim of this article is to summarize the latest information on microbicide formulations for prevention of sexual transmission of HIV infection in women. Recent findings: Although early microbicide formulations were conventionally coitally dependent gel products, new technologies are being developed for vaginal delivery of anti-HIV agents. Intravaginal rings for delivery of microbicides, for example, are being developed and evaluated clinically. Safety and acceptability data are available for many microbicide gels and for one microbicide intravaginal ring. Other microbicide formulations in development for once daily or other vaginal administration strategies include films, tablets, and ovules. Various microbicide formulations for rectal administration are also in development. Summary: New microbicide formulations in development are addressing many of the issues with the original gels such as coital dependency, frequency of use, acceptability, compliance, cost, and adaptability to large-scale production. All of these dosage forms are promising options for safe, effective, and acceptable microbicide products.

Safety and Pharmacokinetics of Dapivirine Delivery From Matrix and Reservoir Intravaginal Rings to HIV-Negative Women

Vaginal microbicides for the prevention of HIV transmission may be an important option for protecting women from infection. Incorporation of dapivirine, a lead candidate nonnucleoside reverse transcriptase inhibitor, into intravaginal rings (IVRs) for sustained mucosal delivery may increase microbicide product adherence and efficacy compared with conventional vaginal formulations. Twentyfour
healthy HIV-negative women 18–35 years of age were randomly assigned (1:1:1) to dapivirine matrix IVR, dapivirine reservoir IVR, or placebo IVR. Dapivirine concentrations were measured in plasma
and vaginal fluid samples collected at sequential time points over the 33-day study period (28 days of IVR use, 5 days of follow-up). Safety was assessed by pelvic/colposcopic examinations, clinical laboratory tests, and adverse events. Both IVR types were safe and well tolerated with similar adverse events observed in the placebo and dapivirine groups. Dapivirine from both IVR types was successfully distributed throughout the lower genital tract at concentrations over 4 logs greater than the EC50 against wild-type HIV-1 (LAI) in MT4 cells. Maximum concentration (Cmax) and area under the concentration–time curve (AUC) values were significantly higher with the matrix than reservoir IVR. Mean plasma concentrations of dapivirine were ,2 ng/mL. These findings suggest that IVR delivery of microbicides is a viable option meriting further study.

Rheological characterization of thermoresponsive semisolids for vaginal HIV vaccine delivery

Purpose. To manufacture and characterize, through oscillatory rheology, thermoresponsive rheologically structured vehicles
(RSV’s) capable of enhanced retention times within the vagina for the purposes of HIV vaccine delivery.
Methods. Pluronics F127, F108 and F68 were investigated and RSV’s were prepared by dissolving sorbic acid (0.1% w/w)
and mucoadhesive component (Gantrez SBF97 or Noveon AA1, 3% w/w) in the required amount of H2O and NaOH.
Pluronic (10% w/w) was added via mixing in an ice-bath followed by hydroxyethylcellulose (5%) and subsequently
poly(vinylpyrollidone) (4%w/w). Oscillatory temperature sweeps between 10-38°C were preformed within the linear
viscoelastic region of the formulations on an AR2000 rheometer (T.A. Instruments, Surrey, England) with a 2cm diameter
parallel plate geometry and a plate gap of 1000µm at 1Hz.