The grant allows Landay and his international team of researchers to test three different assays to determine which best assesses CD4 cell counts in HIV positive patients in rural or under developed countries.
Landay said one of the big problems facing under developed countries is finding a test that can tell physicians or public health care workers when an HIV positive patient's CD4 cell count falls under 200, which is when the patient needs antiviral therapy.
For this study, Landay's team has selected Bali, a country off the coast of Australia. Many countries like Bali do not have the infrastructure to support more sophisticated HIV and CD4 cell counting technology -- the gold standard for such tests is the flow cytometer, which costs $150,000 and requires electricity and advanced computer technology. Bali was also selected because there is evidence of a rapidly expanding HIV epidemic in that country, created by drug users and commercial sex workers. According to surveys done on those patients, approximately 50 percent of the drug users are HIV positive.
"Doctors in these areas of the world simply do not have the resources to use state of the art CD4 testing," Landay said, pointing out that there are now 42 million people worldwide with AIDS. A field assay, such as those Landay is testing for CD4 counts, can provide doctors with immediate test results and they can promptly begin therapy. This also helps reduce the likelihood of the patient failing to return for follow up if the patient has come from a remote location to get treatment, Landay said.
The three assays being testing are a lateral flow assay, a dipstick assay and a capillary tube assay. All three are designed to provide immediate CD4 cell readings, but Landay's study attempts to discover which test combines speed and accuracy when compared with flow cytometer. Each test provides a visual read out in between five and 15 minutes. Results will be confirmed by a flow cytometer test.
These tests were initially developed to test for Hepatitis in the field, giving Landay and his team confidence all three should perform well in these tests.
Landay is collaborating with researchers at the University of Medicine and Dentistry of New Jersey, Newark, N.J., and Macfarlane Burnet Institute for Medical Research and Public Health in Melbourne, Australia.
The mission of the Doris Duke Charitable Foundation (www.ddcf.org) is to improve the quality of people's lives through grants supporting the performing arts, wildlife conservation, medical research and the prevention of child maltreatment, and through preservation of the cultural and environmental legacy of Doris Duke's properties.
Rush University Medical Center is an academic medical center that encompasses an 824-bed Hospital (including Rush Children's Hospital), the 110-bed Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,270 students, is home to one of the first medical schools in the Midwest, one of the nation's top-ranked nursing colleges, as well as graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness neurological disorders and diseases associated with aging.