Highly synergistic drug combination prevents vaginal HIV infection in humanized mice

Sci Rep. 2020 Aug 3;10(1):12995. doi: 10.1038/s41598-020-69937-5.

Abstract

The HIV-1 epidemic remains an urgent global health concern. Young women are disproportionately at risk of acquiring the virus. A range of highly effective, female-controlled, discrete vaginal products therefore is needed to help curb the epidemic. Oral tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) are effective in HIV-1 pre-exposure prophylaxis (PrEP) and form a promising basis for a vaginal product. Here, we evaluate TDF and FTC in combination with the broadly neutralizing antibody VRC01-N using a highly reproducible humanized mouse model. The agents were vaginally dosed individually and in combination, and the efficacy of HIV-1 prevention was analyzed using the established, rigorous median-effect model. Surprisingly, the triple combination showed a high degree of synergism, unprecedented for in vivo HIV-1 PrEP, leading to a possible fivefold dose reduction for some of the agents. Vaginal administration of the TDF-FTC-VRC01-N combination holds significant promise for HIV-1 PrEP.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravaginal
  • Animals
  • Antiviral Agents / administration & dosage*
  • Drug Combinations
  • Drug Synergism
  • Emtricitabine / administration & dosage*
  • Female
  • HIV Infections / prevention & control*
  • Humans
  • Mice
  • Tenofovir / administration & dosage*
  • Vagina*

Substances

  • Antiviral Agents
  • Drug Combinations
  • Tenofovir
  • Emtricitabine