Advances in developing HIV-1 viral load assays for resource-limited settings.
Commercial HIV-1 RNA viral load assays have been routinely used in developed countries to monitor antiretroviral treatment (ART). However, these assays require expensive equipment and reagents, well-trained operators, and established laboratory infrastructure. These requirements restrict their use in resource-limited settings where people are most afflicted with the HIV-1 epidemic. Inexpensive alternatives such as the Ultrasensitive p24 assay, the reverse transcriptase (RT) assay and in-house reverse transcription quantitative polymerase chain reaction (RT-qPCR) have been developed. However, they are still time-consuming, technologically complex and inappropriate for decentralized laboratories as point-of-care (POC) tests. Recent advances in microfluidics and nanotechnology offer new strategies to develop low-cost, rapid, robust and simple HIV-1 viral load monitoring systems. We review state-of-the-art technologies used for HIV-1 viral load monitoring in both developed and developing settings. Emerging approaches based on microfluidics and nanotechnology, which have potential to be integrated into POC HIV-1 viral load assays, are also discussed.
Wang
ShuQi
S
Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Center for Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Xu
Feng
F
Demirci
Utkan
U
D001681:Biological Assay / Q000191:economics / Q000379:methods* / Q000639:trends*; D019049:Developed Countries; D015497:HIV-1 / Q000378:metabolism*; D006295:Health Resources / Q000191:economics*; D006801:Humans; D019095:Point-of-Care Systems; D019562:Viral Load / Q000191:economics / Q000379:methods* / Q000639:trends*