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Research on role of rectal use of personal lubricants in HIV transmission and viral replication in vivo

February 2011

Begay O, Ninochka J-P, Abraham C, et al. Identification of personal lubricants that can cause rectal epithelial cell damage and enhance HIV-1 replication in vitro. AIDS Res Hum Retroviruses 2011;Feb 10 [ePub ahead of print]. [PubMed]

Abstract

Over-the-counter personal lubricants are used frequently during vaginal and anal intercourse, but they have not been extensively tested for biological effects that might influence HIV transmission. We evaluated the in vitro toxicity, anti-HIV-1 activity and osmolality of popular lubricants. A total of 41 lubricants were examined and compared to Gynol II® and Carraguard® as positive and negative controls for toxicity, respectively. Cytotoxicity was assessed using the XTT assay. The MAGI assay with R5 and X4 HIV-1 laboratory strains was used to evaluate antiviral activity. The effect of the lubricants on differentiated Caco-2 cell monolayers (transepithelial electrical resistance, TEER) was also measured. None of the lubricants tested showed significant activity against HIV-1. Surprisingly, four of them, Astroglide® Liquid, Astroglide® Warming Liquid, Astroglide® Glycerin & Paraben-Free Liquid, and Astroglide® Silken Secret™, significantly enhanced HIV-1 replication (p<0.0001). A common ingredient in three of these preparations is polyquaternium-15. In vitro testing of a chemically related compound (MADQUAT) confirmed that this similarly augmented HIV-1 replication. Most of the lubricants were found to be hyperosmolar and the TEER value dropped approximately 60% 2 hours after exposure to all lubricants tested. Cells treated with Carraguard™, saline and cell controls maintained about 100% initial TEER value after 2-6 hours. We have identified four lubricants that significantly increase HIV-1 replication in vitro. In addition, the epithelial damage caused by these and many other lubricants may have implications for enhancing HIV transmission in vivo. These data underscore the importance that more rigorous safety testing should be performed on these products.