HIV testing produces results in minutes and is cheaper

It looks no more complex than a supermarket scanner. But the portable lab device created by graduate researchers at the University of Toronto could radically change the treatment of HIV in developing countries and here in Canada by offering blood testing on the spot and producing results within minutes.

A team led by James Dou, a PhD candidate at the University of Toronto, and his supervisor, Stewart Aitchison, vice-dean of research in the faculty of applied science and engineering, is developing a handheld tool for monitoring t-cells in HIV patients outside of the lab.

Field-testing the “lab-on-a-chip” could begin in local hospitals as early as this summer.

“We’re targeting a global challenge,” Dou says.

HIV weakens the body's immune system by destroying CD4 cells, a group of white blood cells that fight off bacteria, and leaves the patient vulnerable to infection. A crucial part of HIV treatment is monitoring the number of CD4 cells in the blood and administering antiretroviral medication as those numbers drop.

The World Health Organization recommends twice-yearly blood tests for those who are HIV positive. In Canada, tests are conducted quarterly.

The current gold standard for CD4 testing is a machine roughly the size of a photocopier called the flow cytometer, Dou says.

Not only is the flow cytometer bulky, it’s also an expensive piece of machinery that requires a trained technician to operate it. As a result, flow cytometers are typically restricted to large urban centres and are mainly inaccessible to HIV patients in developing nations.

In Canada, those who live in remote communities must send vials of blood away to be tested, with results taking up to two weeks to process.

In contrast, Dou’s portable cytometer works like a diabetes test. A pinprick of blood is placed on the disposable cartridge and inserted into the handheld device, which counts the CD4 cells and produces results in 10 to 15 minutes.

It’s also cheaper. While a test on the flow cyclometer costs between $75 and $100, the lab-on-a-chip will reduce costs to $5-10 a test.

Started as a graduate research project in 2007, Dou’s invention is gaining traction and has garnered the attention of HIV foundations around the world.

The portable cytometer was recently recognized by Grand Challenges Canada, which awarded a $100,000 grant earlier this month to team member Lu Chen, a post-doctoral fellow at the University of Toronto. The grant will be used to test the device in Mozambique, where roughly 16 per cent of the adult population is living with HIV.

“The exercises go one step further than research,” Aitchison says. “We know the concept works in the lab. We’ve got trained people loading the sample and running the software that does the counting.”

Lab-on-a-chip technology has been around for a long time, he says. The real innovation comes from packaging the device in a way that allows a skilled person, such as a nurse practitioner, to use it in the field.

Dou envisions the mobile test bolstering the healthcare infrastructures of developing nations by creating widespread access to CD4 monitoring.

Its adoption at home will benefit Canada’s healthcare system by reducing costs and wait times for testing. It will also help improve service to vulnerable populations by taking the mobile test straight to the people who need it most.

“We want to build a commercial product,” Dou says.

To that end, the team turned to the University of Toronto’s Innovations and Partnership’s office, which helped them establish a company to manage the business side of the product. ChipCare Corporation will take on the commercialization plan of the portable cytometer.

They hope that Dou’s lab-on-a-chip will spark a new high-tech industry in Toronto that rivals Silicon Valley or Boston.

“If you look around the downtown Toronto core, there’s a lot of good healthcare research going on, but there is a lack of industry support for us to compete,” Dou says.

The dearth of commercial funding also creates a brain drain, sending many graduate researchers to the United States, he says. Dou would like them to find work at home.

“Canada generates as many good ideas as other countries,” Aitchison says. “But we don’t translate those ideas into as many products or knowledge.”