New Technologies and Innovations in Laboratory Support of HIV/AIDS care and Treatment

1. New Technologies and Innovations in Laboratory Support of HIV/AIDS care and Treatment Dr. Thaweesak Tirawatnapong Chula Medical Research Center (Chula MRC)

2. Diagnostics Tests for HIV • 1 Tests to facilitate initial diagnosis • 2 Tests to stage the patients • 3 Tests to monitor the patients

3. Important of HIV Testing • Known HIV status for care and treatment • For prevention measure • Problem • Poor HIV testing coverage in resource- limited Setting

4. General Community Requirement • Need to increase the level of access to high quality diagnostic in resource-limited settings • To facilitate early detection and treatment of HIV/AIDS • Simplify and improve the efficiency of HIV testing • Tests design to be delivered at The point of care (POC) or Near POC

5. The Various PCR Process have Three Steps in Common • 1. Sample preparation, including viral concentration and nucleic acid extraction. • 2. Amplification of the target DNA or RNA. • 3. Detection of the amplified product.

6. DNA Extraction Flow with Magtration Technology

7. Automated Nucleic Acid Extraction

8. Extraction and PCR Set Up Qiagen Symphony Cobas Ampriprep

9. COBAS® S 201 System for Blood screening 

10. Chiron Tigris for Blood screening

12. New Technologies for Viral Load Testing • Alere NAT system disposable cartridge that provides for sample collection, cell lysis, specific target capture, reverse transcription, polymerase chain reaction amplification and real time fluorescence detection based on reporter probe hybridization on an integrated micro probe array.

14. Lab-in-a-tube Technology The Liat System automates all testing processes Sample preparation Amplification Real-time detection

15. Portable Fully Automate real-time PCR

16. The Liat™ Analyzer is developed for nucleic acid based testing and the Liat™ Tubes serve both as collection devices and as test chambers, maintaining samples in a closed system from sample collection through sample disposal. We believe that the Liat™ system is suitable for a wide range of testing labs and near-patient test settings due to its ease of use, fast turnaround time, cost effectiveness and safety features.

18. SAMBA: Simple AMplification Based Assay

21. Cepheid GeneXpert System

22. GeneXpert Cartridge and Module

24. Lab-on-Chip

27. Handy Lab

28. Microfluidic Technology

30. Nucleic acid extraction

32. QP system

37. BIST: Beads array In Single Tip

39. New HIV Drug resistant testing • Minisequencing or Single base extension

44. Bio-Strands Technology

45. Nanostring Technology

46. Hybridization NanoString’s Technology employs two ~50 base probes per mRNA that hybridize in solution. The Reporter Probe carries the signal; the Capture Probe allows the complex to be immobilized for data collection

47. Purification and Immobilization After hybridization, the excess probes are removed and the probe/target complexes aligned and immobilized in the nCounter Cartridge.

48. Data Collection Sample Cartridges are placed in the Digital Analyzer for data collection. Color codes on the surface of the cartridge are counted and tabulated for each target molecule

49. nCounter Analysis System • High level of precision • High level of sensitivity (<1 copy per cell) • No enzyme processing or Amplification • Quantification

50. Multiplexed Diagnostic • LLNL Awarded $2.5M to Move Pathogen Detection Tests to NanoString Platform • June 07, 2011 • The National Institutes of Healthhas awarded $2.5 million to researchers at Lawrence Livermore National Laboratory to support the development of pathogen detection assays on NanoString Technologies' nCounter system. • The project aims to develop high-content, multiplex assays capable of simultaneously detecting 35 National Institute of Allergy and Infectious Diseases category A, B, and C viral agents, plus quantifying cytokine and chemokine responses in patients,