A new battlefront: .

• Author: Thaler, Sebastian
• Position: Medicine & Health - AIDS

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THE OBAMA Administration has unveiled a national strategy to curb the AIDS epidemic. It is calling for steps to reduce the annual number of new infections by 25% within five years and increase the number of people who receive treatment. Pres. Barack Obama does not propose a major jump in Federal spending, but rather advocates the redirecting of existing funds to areas with the greatest need and to population groups at the greatest risk.

According to estimates that were published in October 2008 by the Centers for Disease Control and Prevention, a total of 1,106,400 adults and adolescents were living with HIV infection in the U.S. at the end of 2006. In addition, approximately one in five people with HIV was unaware that he or she had been infected. In its report on these statistics, the CDC went on to comment that the growing number of Americans with HIV pointed to an increased need for testing, treatment, and prevention services to slow the epidemic. Since fewer people in the U.S. are dying from AIDS than in earlier years, quality-of-life issues for those living with HIV have come to the fore.

Testing is one of the most important steps individuals can take to protect their health and that of those around them. Once an HIV test has proven positive, getting a patient on early treatment reduces AIDS-related deaths by 50% to 60% and improves the health and quality of life of thousands of people living with HIV. Early treatment also has proved capable of lowering viral levels and the potential for HIV transmission to others by 60%.

One type of chemical test, known as the immunoassay, is used to detect or quantify a specific substance, known as the analyte, in a blood or body fluid sample, using an immunological reaction. Immunoassays are a key element in the diagnosis of various medical conditions, including HIV. Since the mid 1960s, immunoassays have made a major contribution to clinical lab work and, in recent years, have dominated the in-vitro diagnostic product market and represent about one-third of all testing in clinical laboratories. The point-of-care (POC) test market encompasses those diagnostic tests that can be conducted at, or near, the site of patient care. The market for professional POC immunoassays is estimated at $1,625,000,000; with 14% growth, this market segment will reach $2,770,000,000 in 2012.

Health care facilities currently employ a range of standard screening tests for antibodies to HIV. These include the enzyme immunoassay (EIA or ELISA), which is used widely in the U.S. and around the world, as well as Western slots and PCR (polymerase chain reaction)-based assays. EIA requires two visits to a clinic or medical facility: one for patients to receive pretest counseling and to have blood drawn for HIV testing, and a second for them to receive test results and additional counseling (and, if needed, referrals).

In contrast to these traditional tests, a new generation of rapid HIV tests has been developed that have the ability to...