Discussing Point-of-Care at AIDS 2012

There is a lot of buzz for point-of-care at the AIDS 2012 conference in Washington, as testing and diagnostic efforts increasingly move closer to patients.

Point-of-care testing, which is often accomplished through the use of transportable, portable, and handheld instruments, is defined as medical testing at or near the site of patient care, driven by the desire to bring the test to the patient conveniently and immediately.

A session I attended on issues of laboratory monitoring prominently featured point-of-care as an alternative monitoring strategy for antiretroviral treatment in limited resource settings.

The presentation by the Elizabeth Glaser Pediatric AIDS Foundation showed how using point-of-care machines to determine CD4 count levels in people before they can be put on antiretroviral therapy (ART) led to dramatic increase in CD4 testing and initiation of anti-retroviral treatment to HIV-positive women to prevent mother to child transmission of HIV in Zimbabwe.

Although some questioned the reliability of point-of-care for CD4 test machines due to the breakdown rate, there was general consensus that point-of-care testing serves as a good entry point, and is key to monitoring the quality of HIV care and treatment in resource-limited settings.

From various presentations made – including viral load testing in Malawi and use of dried blood samples to monitor patients (children) in rural areas on ART in Zimbabwe – there was general agreement that point-of-care increases the likelihood that the patient, physician, and care team will receive the results more quickly – which gives doctors and medical professionals the opportunity to make immediate clinical management decisions.

Participants agreed that viral load and CD4 testing should be made simpler and more available to enhance the quality of HIV care and treatment services.

This discussion was taking place even as an Australian-based manufacturer, Omega Diagnostics, announced a stand-alone, inexpensive, disposable, rapid-point-of-care test for determining CD4 T-cell counts in HIV-infected patients to be released in the market in December of this year.

From a time when CD4 test machines required no less than a single-phase alternating current power source to our new battery-operated rapid CD4 test kit, technology has become a tool to help meet unmet needs and enhance quality HIV care and treatment, even as other initiatives for treatment and cures continue.