HIV incidence assays: distinguishing recent from long-term HIV infections

The 2008 report on the global AIDS epidemic found that since 1981 HIV caused an estimated 25 million deaths worldwide. Despite the success of antiretroviral drugs in slowing the rate of AIDS deaths, HIV still remains a very challenging public health problem. As of 2007, about 33 million people in the world were living with AIDS. There is an incredible need for improved diagnostics to provide more rapid and sensitive identification of the virus and help control the continued spread of HIV.

New HIV infections occur faster than people can be treated, and such infections must be prevented to control the epidemic. Recognizing the most recent infections at the individual level would allow prevention programs to target those areas more effectively. This could then slow the HIV infection rate dramatically. Dr. Bharat Parekh of the Centers for Disease Control and Prevention (CDC) led a team that developed several unique tests that not only detect HIV-1, but also identify how recently a person has been infected with it, thus allowing for identification of HIV infection hot spots. The CDC scientists created a unique multisubtype recombinant protein, developed from HIV-1, that could identify all strains of HIV-1. The new protein can be expressed and purified from E. coli, which greatly simplifies the production process while enabling production of substantially larger quantities of protein.

Dr. Parekh disclosed his inventions to the CDC Technology Transfer Office, which resulted in licenses to companies in the United States, Ireland, India, and China. He provided these companies with information and biological materials to replicate the tests. His laboratory members trained key scientists from the companies in a hands-on approach to ensure the successful transfer of technology. CDC staff worked closely with company personnel to ensure the consistency of the test kits developed for all of the testing assays.

Dr. Parekh’s efforts led to groundbreaking assessments of new infection rates in the United States and South Africa. His tests have been used in many countries, including Brazil, India, China, Thailand, Botswana, Ethiopia, Germany, Peru, and Canada. Currently, he is transferring new technologies to the companies for newer improved test kits. The result of this technology transfer will lead to better detection and surveillance of HIV, thereby indicating where prevention programs should be implemented.
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