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While there are several broad classes of microbicides, three major ones are described.
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The most important class of microbicides target HIV-1 and contain antiviral agents formulated for topical vaginal delivery.
McCormack says the data mark the end of the road not just for this vaginal gel but the whole class of microbicides that use nonspecific compounds to prevent HIV-infection.
One class of microbicides bolsters the natural physiological conditions of the vagina by providing a pH buffer (e.g. BufferGel and ACIDFORM) [9], [10].
A third class of microbicides interferes with the life cycle of HIV-1 and includes drugs that are currently used for treatment (e.g. tenofovir) or have been evaluated for treatment (e.g. UC781 and Dapivirine).
A second class of microbicides blocks the fusion of HIV-1 with its target cells and is a large group with diverse structures; examples include cellulose sulfate, Carraguard, and PRO 2000.
89 The other broad class of microbicides under development is vaginal milieu protectors that work to maintain, restore, or enhance the natural protective mechanisms within the vagina.
In summary, the pH-responsive crosslinked polymer system reported here holds promise as a class of microbicide delivery vehicle that could inhibit the transport of virions from semen to the target tissue and, thereby, contribute to the overall activity of the microbicide formulation.
Another broad class of microbicide agents are the fusion or entry inhibitors that block either attachment of HIV-1 to the host cells, the fusion of virus and host cell membranes, or the entry of HIV-1 into the host cells.
Despite the development of several different classes of topical microbicides, none have proven safe and effective at HIV prevention.
Finally, the current review includes a quantitative synthesis of all currently available effectiveness data from experimental vaginal microbicides; but the Cochrane review conducted a narrative synthesis of effects across the different classes of non-nonoxynol-9 microbicides.
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