HIV diagnosis is The Root of most of the problems we have in HIV World.

“How can we get more people antiretrovirals?”… How can you give someone antiretrovirals before they have been diagnosed with HIV?

“How can we stop HIV transmission to sexual partners?”… Condoms work, but why would you insist people in committed monogamous relationships  wear condoms if neither one was HIV positive?

“How can we stop HIV transmission to babies?”… Pre-birth antiretrovirals work, but why would you give an expectant mom anti-HIV drugs if she was not HIV positive?

We need to know if someone is HIV+ before any of these other problems become problems.

Roughly 20% of the people infected with HIV do not know it. Sure, some of that it because people wont/are afraid to get tested.  But some people cant get tested. They cant afford it, their physicians cant afford it, their governments cant afford it. Not just the gross cost of reagents and man-power for people trained to do/interperet HIV tests– The equipment to read the tests (ELISA plate readers, Western Blot imagers, Real-Time PCR machines) is beyond cost prohibitive (and quite useless if you do not have electricity).

Literally and philosophically– How do you solve a problem you cannot see?

Well, the smart-ass answer would be “Make an HIV test you can read/see with the naked eye”.

Apparently, the smart-ass answer is the right answer:

Plasmonic ELISA for the ultrasensitive detection of disease biomarkers with the naked eye

It looks like a totally easy idea to implement:

  1. Take something that already works for HIV-1 detection, an ELISA, and make it a liquid (‘plasmonic’, lol).
  2. Take the readout from an ELISA (requires a machine) and make it easy to read with the naked eye (“coloured nanoparticle solutions of characteristic tonality” aka blue=positive, red=negative).
  3. Make sure its super sensitive. Like, just as sensitive as an extremely expensive Real-Time PCR protocol.

See? Totally simple!

LOL!

Conceptually it is simple, but what they had to do to make this actually work… I dont want to know the trail of trouble-shooting and epic failures behind this innovation, but it is absolutely fantastic. Basically, if no HIV proteins are there, the nanoparticles in this solution remain dispersed, and the solution looks red.  If HIV particles are there, the nanoparticles start sticking together, a chemical reaction occurs, and the solution looks blue.

No super special (read: expensive) plates or equipment needed, just mix everything together.

Of course, it would suck if the test only worked if you were REALLY HIV positive, and had LOTS of HIV proteins around for this reaction to work.  Certainly it would still have some utility, but we want an HIV test to be very sensitive, so you dont send someone home with an HIV- diagnosis when they are actually HIV+.

The ‘gold standard’ of HIV tests, RT PCR, can detect <50 copies/ml, but there is no way you could get the reagents/equipment/etc out to a farming town in rural Zambia.

What can this test do?

p24 was also detected with the naked eye in the sera of HIV-infected patients showing viral loads undetectable by a gold standard nucleic acid-based test.

I could hardly believe that, but they put pics of the assays in the paper. The tests from HIV- people are pink, the tests from HIV+ people with high or undetectable-by-gold-standard viral loads is a bluish purple.

Detection of HIV is the FIRST problem we have in HIV World. This looks like a pretty damn exciting solution!

Comments

  1. #1 Nick Theodorakis
    November 2, 2012

    “Plasmonics” is not just another (“lol”) word for the liquid state. It refers to a property called surface plasmon resonance. More detail in another paper:

    http://www.nature.com/nmat/journal/v11/n7/full/nmat3337.html

  2. #2 Nick Theodorakis
    November 2, 2012

    Coincidentally(?), one of the authors was just featured on the “Women Who Changed The World..” feature on scienceblogs:

    http://scienceblogs.com/usasciencefestival/2012/11/02/women-who-changed-the-world-through-science-engineering-molly-stevens/

  3. #3 Rystefn
    November 2, 2012

    OK, that’s awesome. From a purely pragmatic standpoint, more diagnoses sooner is always useful for any disease. When it’s HIV, that’s an especially big deal.

  4. #4 JustaTech
    November 6, 2012

    Woo! So this is a virus-test, not an anti-body test? (Antibodies take longer to come up, and it’s possible to have them without HIV, if you’ve worked on the vaccines, for example.)

  5. #5 ERV
    November 6, 2012

    Yup! AND it is super sensitive. This really is a super step forward :)

  6. #6 Eric
    November 8, 2012

    ERV, I’ve followed you off and on since P. Zed, name-dropped you years ago on his blog.

    Recently I was listening to the Joe Rogan Podcast (comedian, Fear Factor host, and UFC commentator) and he had Peter Doucheberg (I mean Duesberg) on. I don’t know if you’ve heard of him before, but his claim (to infamy) is that AIDS isn’t caused by HIV. His pet theory is that the gay men who claim to die from AIDS died because they took too many party drugs and stayed out too late at the clubs. Yeah, OK…

    Immediately I remembered your name (how can you remember the moniker ERV?) and thought I’d see what you had to say. You don’t have to waste your time on the full podcast if you can easily dismiss his BS.

    Video:
    http://vimeo.com/53048070

    MP3:
    http://traffic.libsyn.com/joeroganexp/p282.mp3

    Thanks,
    Eric

    ps. I wouldn’t be surprised if he’s also a holocaust denier.

  7. #7 Eric
    November 8, 2012

    On second thought… don’t waste your time on the podcast. I see you’ve thoroughly trashed him before. The guy is such a pathetic loser and should put his money where his mouth is by taking a blood transfusion from an HIV patient.

  8. #8 ERV
    November 8, 2012

    LOTS of us at SciBlogs have commented on Doucheberg (HA! WHY DID I NOT THINK OF THAT???)– Orac, Tara, the Denialism Blog boys, probably missing some.

    WHY would Joe Rogan have him on his show? For that matter, WHY would Doucheberg agree to that?

    Weird :-/

  9. #9 Eric
    November 8, 2012

    Joe has had a boner for this guy since his magazine article in SPIN from 1993.

    He also thinks the Moon landing is a conspiracy and that Sasquatch exists…

  10. #10 Eric
    November 9, 2012

    I found this page and the following quote *begins* to help me understand the baffling position of AIDS denialists:

    “The persistence of the HIV denialism can be understood if we view the movement as a kind of cult. Denialists refer to HIV medicine and science as “the orthodoxy,” giving the field a religious framework, and imagine themselves in an oppositional, visionary role. Many of the features that social scientists find typical of cults characterize the denialists. Most fundamentally, they maintain an intense “us-versus-them” worldview. Those inside belong to an exalted and secretive group — they feel superior but persecuted for knowing a hidden truth. ”

    http://www.thebody.com/content/art57918.html

  11. #11 Poodle Stomper
    November 12, 2012

    Moon landings were faked by Sasquatches to make people believe in HIV. Duh!

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