In vitro inhibition of human papillomavirus following use of a carrageenan-containing vaginal gel

Akiva P. Novetsky, Marla J. Keller, Ana Gradissimo, Zigui Chen, Stephanie L. Morgan, Xiaonan Xue, Howard D. Strickler, José A. Fernández-Romero, Robert Burk, Mark H. Einstein

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objective To assess in vitro efficacy of Divine 9, a carrageenan-based vaginal lubricant that is being studied as a microbicide to inhibit HPV16 pseudovirus (PsV) infection. Methods Sexually active US women between 19 and 35 years without prior HPV vaccination or cervical intraepithelial neoplasia were instructed to use Divine 9 vaginally with an applicator either before sex only or before and after intercourse. Women who applied a single dose of gel returned for cervicovaginal lavage (CVL) collection 1, 4 or 8–12 h after intercourse versus those who applied gel before and after intercourse returned 1, 4 or 8–12 h after the second gel dose. Carrageenan concentrations were assessed using an ELISA assay and the inhibitory activity was assessed using a PsV-based neutralization assay against HPV16 infection. Carrageenan concentrations and the percentage of PsV16 inhibition were compared using the Wilcoxon rank sum test. Results Thirteen women were enrolled and thirty specimens from different time-points were assessed. 87% of CVL samples had detectable carrageenans with levels decreasing over time from intercourse. 93% of CVL samples had detectable PsV16 inhibition with median inhibition of 97.5%. PsV16 inhibition decreased over time, but remained high, with median inhibition of 98.1%, 97.4% and 83.4% at 1, 4 and 8–12 h, respectively. Higher carrageenan concentrations were associated with higher levels of PsV16 inhibition (rho = 0.69). Conclusions This is the first report of a human study investigating in vitro HPV inhibition of a carrageenan-based vaginal lubricant with CVL collected after sexual intercourse. We demonstrate excellent efficacy in preventing PsV16 infection.

Original languageEnglish (US)
Pages (from-to)313-318
Number of pages6
JournalGynecologic Oncology
Issue number2
StatePublished - Nov 1 2016

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology


  • Carrageenan
  • Cervical cancer
  • Divine 9
  • HPV
  • Prevention


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