Advances in Developing HIV-1 Viral Load Assays for Resource-Limited Settings

Biotechnol Adv. Nov-Dec 2010;28(6):770-81. doi: 10.1016/j.biotechadv.2010.06.004. Epub 2010 Jul 1.


Commercial HIV-1 RNA viral load assays have been routinely used in developed countries to monitor antiretroviral treatment (ART). However, these assays require expensive equipment and reagents, well-trained operators, and established laboratory infrastructure. These requirements restrict their use in resource-limited settings where people are most afflicted with the HIV-1 epidemic. Inexpensive alternatives such as the Ultrasensitive p24 assay, the reverse transcriptase (RT) assay and in-house reverse transcription quantitative polymerase chain reaction (RT-qPCR) have been developed. However, they are still time-consuming, technologically complex and inappropriate for decentralized laboratories as point-of-care (POC) tests. Recent advances in microfluidics and nanotechnology offer new strategies to develop low-cost, rapid, robust and simple HIV-1 viral load monitoring systems. We review state-of-the-art technologies used for HIV-1 viral load monitoring in both developed and developing settings. Emerging approaches based on microfluidics and nanotechnology, which have potential to be integrated into POC HIV-1 viral load assays, are also discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biological Assay / economics
  • Biological Assay / methods*
  • Biological Assay / trends*
  • Developed Countries
  • HIV-1 / metabolism*
  • Health Resources / economics*
  • Humans
  • Point-of-Care Systems
  • Viral Load / economics
  • Viral Load / methods*
  • Viral Load / trends*