Gregory L. Damhorst, Nicholas N. Watkins, and Rashid Bashir
Volume: 60, March Special Issue, Publication Year: 2013
HIV/AIDS disproportionately affects the world’s poorest regions, reflecting the reality that combating the devastation caused by this virus is more complex than the capabilities of state-of-the-art instruments and therapies might lead one to believe. Accessibility to proper care is among the complications which have enabled this pandemic to progress to the point it has: roughly 34 million people living with HIV worldwide. But the age of micro and nanotechnology has promised to bring the tools for optimal treatment to the point-of-care, through diagnostic technologies capable of rivaling the state-of-the-art instruments in the top clinical laboratories and bringing more precise and personalized care to the furthest reaches of the globe.
In this review we discuss recent developments toward portable systems for performing two critical assessments from the blood of the HIV-positive individual. The viral load, which is the enumeration of viruses in plasma, and the CD4 T lymphocyte count, a census of one immune cell subtype, are the core guides used by a healthcare provider to make decisions regarding the administration of antiretroviral therapy for an HIV-positive patient. A brief discussion of the mechanism of host-cell infection and viral replication also illuminates several molecular targets for monitoring viral activity in addition to traditional plasma viral load and CD4 T cell counting. This includes nucleic acid-based detection of the provirus and assays for viral proteins or enzymes. As the capabilities of miniaturized biosensing continue to progress, these creative approaches to HIV detection may prove useful – including steps toward the goal of increasing the prevalence of blood testing through portable platform technologies. Ultimately, we observe several approaches toward a common goal: the capability to perform blood-based diagnostics anywhere via an instrument that fits in the palm of your hand. Read More…