IGF::OT::IGF SIMPLE, INEXPENSIVE UNIT FOR REMOVING CELLS FROM SMALL AMOUNTS OF BLOOD IN RESOURCE-LIMITED SETTINGS

在资源有限的国家推行抗逆转录病毒疗法，大大降低了艾滋病毒的死亡率和发病率。虽然ART方案非常有效，可以将病毒载量(以HIV RNA拷贝数/毫升血浆衡量)降低到无法检测的水平，但在一些患者中仍会发生病毒学失败。在大多数资源有限的环境中，由于检测的成本和复杂性，病毒载量测量不用于常规监测患者的病毒学故障。因此，许多患者没有及时切换到二线治疗方案，这可能会导致耐药性，还有许多其他患者正在不必要地切换到更昂贵的治疗方案。为此，世卫组织目前的建议包括在可行的情况下使用病毒载量测试来监测接受抗逆转录病毒治疗的患者的病毒学失败情况。在接下来的几年里，病毒载量测试的使用预计将大幅增加，其中大部分增长是由于可以在护理点(POC)执行的新的、简单的病毒载量测试。全血中既有血浆中的HIV RNA，也有外周血单个核细胞(PBMC)中的HIV RNA和DNA。这可能会导致检测结果不准确，特别是在检测线性范围的低端，细胞中的HIV RNA和DNA可能占血液样本中总HIV信号的很高比例。需要一种简单、廉价的方法从非常少量的血液中去除细胞，以便与POC HIV病毒载量分析一起使用。细胞的去除必须在POC的一个步骤中非常快速地进行，而不需要电力，并且所产生的血浆必须在POC病毒载量分析中提供准确和可重复性的结果。本次征集的目的是开发一种廉价、易于使用的方法，在用于POC病毒载量分析之前，从手指棒状血样(约500 ul)中去除细胞。

The rollout of antiretroviral therapy (ART) in resource-limited countries has resulted in substantial reductions in mortality and morbidity due to HIV. While ART regimens are very potent and reduce viral load (measured as HIV RNA copies/ml of plasma) to undetectable levels, virological failure still occurs in some patients. In most resource-limited settings, viral load measurement is not used to routinely monitor patients for virological failure due to cost and complexity of the test. Therefore, many patients are not switched to a second line therapy regimen in a timely manner, which can contribute to drug resistance, and many others are being switched unnecessarily to more costly treatment regimens. For this reason, current WHO recommendations include the use of viral load testing where feasible to monitor patients on ART for virological failure. Over the next several years, the use of viral load testing is expected to increase dramatically, with much of the increase due to new, simple viral load tests that can be performed at the point of care (POC). Whole blood contains both HIV RNA in plasma, as well as HIV RNA and DNA in peripheral blood mononuclear cells (PBMCs). This can cause inaccuracies in the test results, especially at the lower end of the linear range of the test, where the HIV RNA and DNA in cells can constitute a high proportion of the total HIV signal in the blood sample. A simple, inexpensive method for removing cells from very small amounts of blood is needed for use with POC HIV viral load assays. Removal of the cells must be performed very quickly in one step at the POC, without the need for electricity, and the resulting plasma must provide accurate and reproducible results in POC viral load assays. The goal of this solicitation is to develop an inexpensive, easy to use process that will remove cells from finger stick blood samples (approximately 500 ul) prior to use in POC viral load assays.