New Technologies and Innovations in Laboratory

Support of HIV/AIDS care and Treatment

Dr. Thaweesak Tirawatnapong

Chula Medical Research Center (Chula MRC)

Diagnostics Tests for HIV

• 1 Tests to facilitate initial diagnosis

• 2 Tests to stage the patients

• 3 Tests to monitor the patients

Important of HIV Testing

• Known HIV status for care and treatment

• For prevention measure

• ProblemProblem• Poor HIV testing coverage in resource-

limited Setting

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

• 1. Sample preparation, including viral concentration and nucleic acid extraction.

• 2. Amplification of the target DNA or RNA.

• 3. Detection of the amplified product.

The Various PCR Process have Three Steps in CommonThe Various PCR Process have Three Steps in Common

DNA Extraction Flow with Magtration Technology

Automated Nucleic Acid Extraction

Extraction and PCR Set Up

Cobas AmpriprepQiagen Symphony

COBAS® S 201 System for Blood screening 

Chiron Tigris for Blood screening

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.

Lab-in-a-tube Technology

The Liat System automates all testing processes

Sample preparation

Amplification

Real-time detection

Portable Fully Automate real-time PCR

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.

SAMBA: Simple AMplification Based Assay

Cepheid GeneXpert System

GeneXpert Cartridge and Module

Lab-on-Chip

Handy Lab

Microfluidic Technology

Nucleic acid extraction

QP system

BIST: Beads array In Single Tip

New HIV Drug resistant testing

• Minisequencing or Single base extension

Bio-Strands Technology

Nanostring Technology

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

Hybridization

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

Purification and Immobilization

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

nCounter Analysis System

• High level of precision• High level of sensitivity (<1 copy per cell)• No enzyme processing or Amplification• Quantification

Multiplexed Diagnostic• LLNL Awarded $2.5M to Move Pathogen Detection

Tests to NanoString Platform• June 07, 2011

• The National Institutes of Health has 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,

• ScienceScience 24 June 2011: Vol. 332 no. 6037 p. 1497

• BIOTECHNOLOGY Lab-on-a-Chip Maker Looks to Put Hong Kong on Biotech Map

RMD Automation Strategy - Maximize Testing Efficiency

Reduce complexity and increase automation, throughput

New Generation systems

Long-Term

Near-Term

cobas 4800

CAP/CTM & cobas s 201cobas s 401

Virology & Blood Screening

Other (HPV, CT/NG, Micro/Oncology)

Complexity Today

LC 2.0

COBAS®

TaqMan® 48

Amplicor

CAP/CTM 96/48 & cobas s 201

cobas s 401

cobas Amplicor