HIV prevention: cream instead of circumcision

Australian scientists from the University of Melbourne, working under the guidance of Professor Roger Short, claim that applying a cream containing the female sex hormone estriol to the foreskin reduces the risk of HIV infection.

The "entrance gate" for the human immunodeficiency virus during sexual intercourse are Langerhans cells, which are part of the inner surface of the foreskin – a special type of macrophages, on the long processes of which there are receptors that allow HIV particles to enter these cells. Infected Langerhans cells migrate to the lymphatic system and spread the virus throughout the body.

The authors found that skin keratin serves as a barrier between Langerhans cells and HIV and prevents infection. As part of the study, they applied estriol cream, which has been the standard treatment for post-menopausal vaginal atrophy for more than 30 years, to the inner surface of the foreskin and assessed the level of keratinization of the region using contact smears.

A single application of the cream per day significantly increased the number of keratinized cells. This effect persisted for at least five days after treatment. Researchers believe that such a thickening of the protective keratinized layer reduces the likelihood of contact between HIV particles and Langerhans cells.

According to the results of earlier studies, circumcision reduces the risk of HIV infection by about 2 times by removing Langerhans cells, which are contained in large quantities in the inner surface of the foreskin.

However, there were cases when men did not wait for the wound surface to heal completely after circumcision, which significantly increased the risk of infection. Short believes that applying estriol cream will speed up the healing process without any side effects. Currently, the authors are conducting clinical trials of estriol as a means to accelerate the restoration of the integrity of the skin after circumcision.

Researchers believe that the cream containing estriol is a promising alternative to circumcision in countries where this procedure is considered culturally unacceptable, including India, China and most countries of Southeast Asia.

Estriol cream can theoretically be used as a lubricant for condoms, which can protect not only men but also women from infection.

Short admits that the study is still at an early stage, but the interest shown by WHO gives him great hopes.

Portal "Eternal youth" www.vechnayamolodost.ru based on ABC Science

06.06.2008