Research Article

Vaginal bacteria modify HIV tenofovir microbicide efficacy in African women

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Science  02 Jun 2017:
Vol. 356, Issue 6341, pp. 938-945
DOI: 10.1126/science.aai9383

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Vaginal microbiome influences HIV acquisition

Tenofovir is a preexposure drug used to prevent HIV infection. In clinical trials, tenofovir was effective for men, but not women. Klatt et al. now show that tenofovir efficacy in women depends on the composition of the vaginal microbiome (see the Perspective by Tuddenham and Ghanem). In a clinical trial of 688 women, tenofovir was three times as effective among those with a Lactobacillus-dominant vaginal microbiome as it was among other women. Gardnerella vaginalis tended to predominate in the women for whom tenofovir was less effective, and the authors found that the organism could rapidly metabolize and thereby inactivate the drug.

Science, this issue p. 938; see also p. 907

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