CD4 counting technologies for HIV therapy monitoring in resource-poor settings--state-of-the-art and emerging microtechnologies.

Authors:
Macdara T Glynn
Macdara T Glynn
Biomedical Diagnostics Institute
David J Kinahan
David J Kinahan
Dublin City University
Ireland
Dr. Jens Ducree, Dr. rer. nat. habil. Dipl. Phys.
Dr. Jens Ducree, Dr. rer. nat. habil. Dipl. Phys.
Fraunhofer Project Centre at Dublin City University
Professor (Full)
microfluidics, Lab-on-a-Chip, hydrodynanmics, business development, project management, organisational leadership
Glasnevin, Dublin 9 | Ireland

Lab Chip 2013 Jul;13(14):2731-48

Biomedical Diagnostic Institute, National Centre for Sensor Research, School of Physical Sciences, Dublin City University, Dublin, Ireland.

Modern advancements in pharmaceuticals have provided individuals who have been infected with the human immunodeficiency virus (HIV) with the possibility of significantly extending their survival rates. When administered sufficiently soon after infection, antiretroviral therapy (ART) allows medical practitioners to control onset of the symptoms of the associated acquired immune deficiency syndrome (AIDS). Active monitoring of the immune system in both HIV patients and individuals who are regarded as "at-risk" is critical in the decision making process for when to start a patient on ART. A reliable and common method for such monitoring is to observe any decline in the number of CD4 expressing T-helper cells in the blood of a patient. However, the technology, expertise, infrastructure and costs to carry out such a diagnostic cannot be handled by medical services in resource-poor regions where HIV is endemic. Addressing this shortfall, commercialized point-of-care (POC) CD4 cell count systems are now available in such regions. A number of newer devices will also soon be on the market, some the result of recent maturing of charity-funded initiatives. Many of the current and imminent devices are enabled by microfluidic solutions, and this review will critically survey and analyze these POC technologies for CD4 counting, both on-market and near-to-market deployment. Additionally, promising technologies under development that may usher in a new generation of devices will be presented.
PDF Download - Full Text Link
( Please be advised that this article is hosted on an external website not affiliated with PubFacts.com)
Source Status
http://dx.doi.org/10.1039/c3lc50213aDOI ListingPossible
July 2013
9 Reads
7 PubMed Central Citations(source)

Similar Publications

Rapid, low-cost and instrument-free CD4+ cell counting for HIV diagnostics in resource-poor settings.

Lab Chip 2014 Aug 9;14(15):2844-51. Epub 2014 Jun 9.

Biomedical Diagnostics Institute, National Centre for Sensor Research, School of Physical Sciences, Dublin City University, Ireland.

We present a novel, user-friendly and widely autonomous point-of-care diagnostic to enable HIV monitoring in resource-poor regions where the current pandemic is most prevalent. To specifically isolate magnetically tagged CD4+ cells directly from patient blood, the low-cost and disposable microfluidic chip operates by dual-force CD4+ cell magnetophoresis; whereby the interplay of flow and magnetic fields governs the trajectory of target cells depending on whether the cell binds to a magnetic microbead. Instrument-free pumping is implemented by a finger-actuated elastic membrane; tagged beads are laterally deflected by a small and re-useable permanent magnet. Read More

View Article
August 2014

CD4+ T lymphocytes enumeration by an easy-to-use single platform image cytometer for HIV monitoring in resource-constrained settings.

Cytometry B Clin Cytom 2007 Sep;72(5):397-407

University of Twente, Faculty of Science and Technology, Biophysical Engineering Group, Building Zuidhorst, Dienstweg 1, 7522 ND Enschede, The Netherlands.

Background: HIV monitoring in resource-constrained settings demands affordable and reliable CD4(+) T lymphocytes enumeration methods. We developed a simple single platform image cytometer (SP ICM), which is a dedicated volumetric CD4(+) T lymphocytes enumeration system that uses immunomagnetic and immunofluorescent technologies. The instrument was designed to be a low-cost, yet reliable and robust one. Read More

View Article
September 2007

Rapid automated cell quantification on HIV microfluidic devices.

Lab Chip 2009 Dec 30;9(23):3364-9. Epub 2009 Sep 30.

Bio-Acoustic MEMS in Medicine Laboratory, Center for Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA.

Lab-chip device analysis often requires high throughput quantification of fluorescent cell images, obtained under different conditions of fluorescent intensity, illumination, focal depth, and optical magnification. Many laboratories still use manual counting--a tedious, expensive process prone to inter-observer variability. The manual counting process can be automated for fast and precise data gathering and reduced manual bias. Read More

View Article
December 2009

The evolution of CD4+ T cell cytometry in perspective: challenges for resource poor settings.

Authors:
O P Arewa

Afr J Med Med Sci 2010 Mar;39(1):5-12

Department of Haematology and Immunology, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.

CD4+ T cell cytometry antedated the Human Immunodeficiency Virus (HIV) epidemic. However it was in the wake of the HIV scourge that CD4+ T cell counting technology gradually evolved from a pure cellular research assay technique into a routine clinical diagnostic test. In the more than two and half decades of the HIV/AIDS pandemic, this cell based diagnostic test has undergone several phases of technological improvements in the efforts to produce cheaper and more robust equipment for the monitoring of patients. Read More

View Article
March 2010