As associate medical director of clinical immunopathology at the University of Pittsburgh Medical Center, Sarah Wheeler has received many calls from clinicians about diagnostic testing in the hospital, including those dealing with human immunodeficiency virus.
However, one call made her realize the limits of modern medical technology.
“We received a call from (UPMC) Magee–Womens Hospital that a woman was in active labor with no prior medical history and no baseline infectious disease testing, and we didn’t have any tests that could provide us an accurate result for her HIV status that could be done rapidly,” said Wheeler, who is also an assistant professor of pathology at Pitt.
This isn’t an uncommon scenario, but it was the event that led to Wheeler and other Pitt researchers taking action. She, along with Michael Shurin, a fellow professor of pathology, and Alexander Star, professor of chemistry at Pitt, are creating a testing device that will be able to determine in one minute whether a patient is infected with HIV. Currently, early HIV screening takes 1,440 minutes — an entire day.
“We thought, ‘We should be able to do something better,’” Shurin said.
Shurin’s tenure in the clinical laboratory took him through the earliest tests for HIV, and he has seen the progress to date in these tests as helpful, but inadequate for the clinical situations he now faces as division director of clinical immunopathology. Building on his decade-long collaboration in cancer research with Star, Shurin started pulling together a team to tackle this problem.
The HIV Detective is the team’s solution to the need for early and rapid diagnosis of HIV. It is a testing platform that would fit in the palm of a hand and allows health care workers to gather a few drops of blood from a patient onto a sensor smaller than Roosevelt’s ear on the dime and provides an HIV screening result in one minute.
This leap forward in testing is possible due to another recent project from the Star laboratory, a working THC breath test.
The THC-detection technology hinges on carbon nanotubes, tiny tubes of carbon 100,000 times smaller than a human hair, which are capable of conducting electricity and monitoring molecular interactions.
“Think of it like wires connected to molecules,” said Star. “The detection is really fast.”
Using the same technology in the HIV Detective means the team members don’t have to wait for the lengthy and insensitive chemical reactions currently used in testing; they can get real-time results from HIV antigen-antibody binding. This allows for a fast and accurate test, as Star’s team has demonstrated with their successful breathalyzer test that also helps in diagnosing and monitoring Type 1 diabetes in patients.
The technology also would allow the team to make the HIV Detective device cost-efficient, which could benefit HIV patients in other countries who cannot afford access to testing. About 34 million people worldwide have the virus.
Patients are most infectious when they first contract HIV, but current rapid tests do not detect HIV in this acute stage — about two to four weeks in. According to the Centers for Disease Control and Prevention, of the 1.1 million people who have HIV in the U.S., about 20% remain unaware they have the virus during this stage because they show no symptoms.
It was this message that helped the HIV Detective team win a $100,000 grand prize from the 2019 Pitt Innovation Challenge (PInCh), hosted by Pitt’s Clinical and Translational Science Institute (CTSI). The prize money will enable the team to create a prototype and use it for clinical trials.
“Our ultimate goal is approval from the Food and Drug Administration, so it can be used across the country,” Wheeler said.
“The PInCh competition provides the opportunity for University teams to identify important medical and public health problems and address those problems with unique solutions,” said CTSI director Steven Reis, who also is associate vice chancellor for clinical research and health sciences, and a professor of medicine at Pitt. “This year’s winners — including HIV Detective — proved, once again, that through creative thinking by diverse research teams, discoveries can be applied to address real world health challenges.”