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
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Contact: Chris Martin
cmartin@rsh.net
312-942-7820
Rush University Medical Center
16-Sep-2003