Penn researchers work to improve HIV care in low-resource settings

Treatment for HIV has come a long way since the illness emerged as a serious global health problem in the 1980s. With constant monitoring and the right cocktail of medication, patients with HIV can now live long, healthy lives.

But unfortunately, many individuals who are diagnosed with HIV don’t have access to the proper diagnostics and treatment.

“In the U.S., someone taking medication would check the viral load every once in a while to make sure nothing is going wrong,” says A.T. Charlie Johnson, a professor of physics in the School of Arts & Sciences. “But these techniques are expensive and they require high-tech hospitals, so in low-resource settings like Africa, this monitoring is not done. You might have a person taking medication, but something has happened and the viral load is going way up and they don't know it until the person has very severe symptoms.”

To tackle this global problem, a team at Penn is using commercially available nanotechnology to develop a low-cost, handheld diagnostic device that can monitor HIV. Not only would this device increase access to high-quality treatment of HIV in developing countries and disadvantaged parts of the world, it would also lower the cost of health care in the United States.

The project is led by Johnson, David Issadore, an assistant professor in the School of Engineering and Applied Science, and Ronald Collman, a professor in the Perelman School of Medicine and director of the Penn Center for AIDS Research.

In November, the team was awarded a Gates Grand Challenges Exploration Grant from the Gates Foundation with an initial award of $100,000, and the opportunity to receive follow-on funding of up to $1 million if they can successfully prove their technology.

The current technique for counting the amount of the virus in a patient’s blood is both expensive and slow.

In order to achieve the same sensitivity in a handheld chip, the group at Penn is working to combine two different technologies. Issadore’s group isolates the virus using magnetic nanoparticles and Johnson’s group uses graphene sensors to search for pieces of RNA that are specific to HIV.

In addition to improving treatment of HIV in low-resource settings by supplying a low-cost, portable diagnostic device, Issadore says this technology could become important in the next generation of HIV treatment.

One of the roadblocks to developing a cure is that when patients are given medication, the amount of the virus in their blood will continue to drop until it goes below the level of sensitivity of the current tests. Because of this, the only way to know if the treatment has worked is to take it away and wait to see if the disease comes back.

Issadore says these ultrasensitive detectors might have the potential to measure HIV at even lower levels, which could speed up the process of developing a cure.

But for now, the immediate goal of the project is to improve and merge the two technologies, and eventually move beyond working with artificial samples with a known amount of the virus to working with samples from patients in sub-Saharan African countries, such as Botswana, to see if the device works.

“We’re great at managing HIV, but currently we’re not as good at making that care accessible to everyone,” Issadore says. “What Charlie and my lab are developing aims to take the technology currently only accessible to people who live near well-equipped hospitals and bring that level of care to everyone in the world.”

HIV Care