Contributed Commentary by David Fraser
June 28, 2018 | With shocking recent statistics showing that gay African American men in the US face a 50% chance of contracting HIV, it’s clear that the hard-fought battle against HIV is far from over. Huge strides have been made to tackle the virus, leading former President Barack Obama to declare an “AIDS free generation” was within reach in a speech in 2014, but recent statistics highlight many communities where HIV is still rife.
This is no time for complacency.
Continued growth and progress is needed—and developing innovative diagnostics to create an effective first line of defense against HIV, is crucial.
Investment in diagnostics to reach resource-poor areas in the point-of-care setting is vital, both in developing countries and across often-overlooked communities in developed countries. Diagnostics need to be accessible, inexpensive, and consumer-friendly.
Lateral flow tests offer a cost-effective and easy-to-use solution. However, targeting HIV effectively is challenging and requires consistent innovation. Unlike many viral infections, HIV patients often seek diagnosis after a suspected exposure or as part of routine or mandated testing rather than in response to symptoms like most infectious diseases, compromising the typical viral diagnostic method of measuring the body’s immune response in a serology capture assay.
To meet that challenge of creating a comprehensive diagnostic solution, current fourth and fifth generation tests combine serology approaches for HIV-1 and HIV-2 with an antigen capture of the p24 capsid protein of HIV. These offer a sensitivity adequate for supporting commercially available assay goals of achieving “post-event” diagnosis, generally within days of exposure.
Improving and enhancing existing technology to boost the sensitivity of rapid lateral flow HIV tests and ensure that suspected sufferers can be even more rapidly and accurately identified, is also key.
Advances in lateral flow technology is helping to boost test sensitivity and improve the limit of detection and time-to-result for situations where a quick diagnosis is critical to patient care. Thus optimized, lateral flow tests can play an even more effective role in the battle to diagnose and combat the spread of infectious diseases.
Other areas of technological innovation are also gaining increasing importance as we move forward in the battle to tackle AIDS. mHealth, particularly mobile-enabled point-of-care testing (POCT), is playing a key role in enabling an early and accurate diagnosis at the point-of-care.
Mobile enabled point-of-care technology is particularly valuable in hard-to-reach, rural communities, but it also has an important role in enabling testing where the social stigma of HIV might prevent people going to clinics to get tested.
We’re increasingly seeing the benefits of mobile technology in all sorts of health care applications and it is an increasingly valuable tool that enables people to rapidly and accurately self-test from the privacy of their own homes, with the results shared securely with healthcare professionals online.
Combatting complacency and committing real energy to continual innovation is key if we are ever to reach Obama’s vision of an AIDS-free generation. We are some way off from that point, and more work needs to be done to ensure the biotechnology community is working smart to deliver rapid, inexpensive, accurate diagnostics to the most vulnerable populations globally.
David Fraser is the Lateral Flow Product Manager at BBI Solutions. Within this role it is his responsibility to be an internal and external champion of BBI Solutions’ Lateral Flow products and services, to understand the market and ensure that the suite of services BBI Solutions offers meets their customers’ needs. He can be reached at davidfraser@bbisolutions.com.