Streamlined 15-min HIV Viral Load Self-Testing Using Finger-Stick Blood

使用指尖采血进行简化的 15 分钟 HIV 病毒载量自检

• 批准号: 10219140
• 负责人: Yu-Hsiang Hsieh
• 金额: $ 47.55万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219140
• 关键词: AIDS prevention; Accident and Emergency department; Accreditation; Acquired Immunodeficiency Syndrome; Acute; Baltimore; Biological Assay; Blood; Buffers; Car Phone; Cessation of life; Charge; Chronic Disease; Clinic; Clinic Visits; Clinical; Clinical Management; Cold Chains; Collaborations; Communicable Diseases; Complex; Consent; Consumption; Detection; Development; Devices; Drug resistance; FDA approved; Filtration; Fingers; Fluorescence; Freeze Drying; Goals; Gold; HIV; HIV Infections; Health Policy; Human immunodeficiency virus test; Infection; Institutes; Interruption; Intervention; Laboratories; Lead; Liquid substance; Magnetism; Manuals; Membrane; Methods; Microfluidics; Miniaturization; Monitor; Nucleic Acids; Patients; Performance; Persons; Phase; Plasma; Preparation; Prevention strategy; Process; Protocols documentation; Public Health; RNA; Reaction; Reagent; Recording of previous events; Rehydrations; Resources; Sampling; Schedule; Science; Self Administration; Site; Surveys; Techniques; Technology; Test Result; Testing; Time; Training; Translating; Uganda; Venipunctures; Viral; Viral Load result; Visit; Waxes; Whole Blood; World Health Organization; acute care; acute infection; amplification detection; antiretroviral therapy; base; cost; detection assay; detection limit; diagnostic technologies; high risk population; home test; improved; instrument; instrumentation; miniaturize; multidisciplinary; novel; nucleic acid purification; operation; particle; portability; prevent; reconstitution; resistance mutation; response; seal; self testing; tool; transmission process; user-friendly; validation studies; viral rebound; virology

The revolutionary advances in human immunodeficiency virus (HIV) antiretroviral therapy (ART) which could reach and maintain viral suppression have gradually transitioned HIV/acquired immunodeficiency syndrome (AIDS) to a manageable, chronic disease in the past 2 decades. However, it is still one of the leading public threats in the world with approximately 37.9 million people living with HIV (PLWHA), 1.7 million new infections, and 770,000 HIV-related deaths in 2018. As a comprehensive strategy for improving the clinical management of HIV, the World Health Organization (WHO) specifically calls for improved accessibility of not only ART, but also HIV testing to reach untested high-risk populations and to help PLWHA ascertain their viral load (VL) and potential for transmission. In response, this project seeks to develop a diagnostic technology for rapid, affordable and easy-to-use HIV VL detection that is amenable for self-testing and even in-home testing. Unlike conventional diagnostic technologies that are impractical for self-testing due to requirements of sophisticated devices and instruments, our platform employs magnetofluidic technology to replace bulk fluid transport with magnetic particle manipulation, enabling the integration of sample processing and PCR without the need for complex fluidic cartridges and supporting instrumentation. Miniaturization of instrumentation and assay facilitated by magnetofluidics minimizes reagent consumption and the thermal mass, leading to >10-fold reduction in cost and assay time. The integrated device facilitates HIV RNA detection from finger-stick blood in a facile “sample-to- answer” manner, promising a rapid, inexpensive and user-friendly strategy for VL self-testing. We have assembled a multi-disciplinary team with complementary expertise and strong track record and history of collaboration in team science. In order to achieve the above goal, we propose (i) to develop a streamlined assay protocol for sample processing and PCR detection of HIV in whole blood, (ii) to develop an inexpensive magnetofluidic cartridge implementing the HIV detection assay as a simple blood-to-result test, (iii) to develop a portable instrument to enable facile HIV self-testing, (iv) to develop a method for ambient cartridge storage, and finally (v) to evaluate performance and patient acceptability of the HIV self-testing platform in both acute care and resource-limited settings. The development of this HIV VL self-testing technology has the potential for dramatically increasing the accessibility of detecting acute infections and monitoring viral suppression in PLWHA, thus presenting a game changer in the global HIV prevention strategy.

人类免疫缺陷病毒（HIV）抗逆转录病毒疗法（ART）的革命性进展可以