HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of…
HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of HIV-1 RNA in blood. However, viral load assays are not widely available in sub-Saharan Africa and cost between 50-$139 USD per test on average where available. To address this problem, a mixed-methods approach was undertaken to design a novel and inexpensive viral load diagnostic for HIV-1 and to evaluate barriers to its adoption in a developing country. The assay was produced based on loop-mediated isothermal amplification (LAMP). Blood samples from twenty-one individuals were spiked with varying concentrations of HIV-1 RNA to evaluate the sensitivity and specificity of LAMP. Under isothermal conditions, LAMP was performed with an initial reverse-transcription step (RT-LAMP) and primers designed for HIV-1 subtype C. Each reaction generated up to a few billion copies of target DNA within an hour. Presence of target was detected through naked-eye observation of a fluorescent indicator and verified by DNA gel electrophoresis and real-time fluorescence. The assay successfully detected the presence of HIV in samples with a broad range of HIV RNA concentration, from over 120,000 copies/reaction to 120 copies/reaction. In order to better understand barriers to adoption of LAMP in developing countries, a feasibility study was undertaken in Tanzania, a low-income country facing significant problems in healthcare. Medical professionals in Northern Tanzania were surveyed for feedback regarding perspectives of current HIV assays, patient treatment strategies, availability of treatment, treatment priorities, HIV transmission, and barriers to adoption of the HIV-1 LAMP assay. The majority of medical providers surveyed indicated that the proposed LAMP assay is too expensive for their patient populations. Significant gender differences were observed in response to some survey questions. Female medical providers were more likely to cite stigma as a source problem of the HIV epidemic than male medical providers while males were more likely to cite lack of education as a source problem than female medical providers.
Ian Hector Frazer studied the human immune system and vaccines in Brisbane, Australia, and helped invent and patent the scientific process and technology behind what later became the human papillomavirus, or HPV, vaccinations. According to the Centers for Disease Control and Prevention of the US, or CDC, HPV is the…
Ian Hector Frazer studied the human immune system and vaccines in Brisbane, Australia, and helped invent and patent the scientific process and technology behind what later became the human papillomavirus, or HPV, vaccinations. According to the Centers for Disease Control and Prevention of the US, or CDC, HPV is the most common sexually transmitted infection, and can lead to genital warts, as well as cervical, head, mouth, and neck cancers. Frazer and virologist Jian Zhou conducted research in the 1990s to assess why women with HPV had higher rates of precancerous and cancerous cervical cells. Frazer’s research led the pharmaceutical company Merck to produce the Gardasil vaccination series, and GlaxoSmithKline to produce the Cervarix vaccination. Frazer’s research contributed to the development of HPV vaccinations that have been successful in reducing up to seventy percent of cervical cancer cases in women.
