Implementing rapid molecular technologies for TB tests that significantly reduce the time of diagnosis to two hours as opposed to six weeks, as well as molecular technologies for early infant HIV diagnosis, HIV viral load testing and CD4 testing, is part of the work currently being carried out by the University of Witwatersrand’s department of molecular medicine and haematology.
These life-changing technologies’ implementation in South Africa and impact as a whole on global HIV and TB health will be discussed by Professor Wendy Stevens and Professor Lesley Scott at the University of the Witwatersrand’s faculty of health sciences 13th Prestigious Research Lecture on 14 June 2016.
Prof. Stevens is the head of department of molecular medicine and haematology in the school of pathology at Wits University. She is also the head of the national priority programme (NPP) of the National Health Laboratory Services (NHLS). Together with the national department of health, the NHLS and clinical stakeholders, Prof. Stevens put together the policy for the use of molecular technologies in South Africa - the first country to roll this out to scale. Prof Scott is the head of research and development for the NPP.
Titled "Unlocking access to global HIV and TB care through molecular diagnostics", the professors will shed light on the simple, quick, ingenious molecular technologies their teams have tirelessly worked on to use molecular technologies to improve patient care.
Given the HIV and TB co-epidemic in South Africa - where our TB-infected population has up to 65% coinfection with HIV, this is a revolution in patient healthcare that could save millions of lives.
“As a result of the use of an automated molecular diagnostic machine for TB called GeneXpert, for example, over 80% of individuals with multi-drug resistant TB, which is highly infectious, and 60% fatal, can immediately be identified. The quick turnaround for results means that patients don’t go missing or infect others or die, as happened previously. In 2014, for example, approximately 9,6m people developed TB and 1,5m died globally,” says Prof. Stevens.
TB diagnosis can now be done at the patient’s bedside, irrespective of whether they are in a rural clinic or city hospital, but before such testing can be done on the machines, they must be checked that the technology is working properly. This process was almost impossible to do. “Not only would it take several weeks, it also posed a severe biosafety risk because it meant transporting live organisms, sometimes over great distances,” explains Prof. Scott.
Molecular technologies are also being used in HIV early infant diagnosis (EID) to determine whether the HIV virus DNA is present, and these technologies are also being used to test HIV viral loads and CD4 counts.
“It is all about choosing the right technology and getting it to the right patient at the right time,” says Prof. Stevens, whose team has been using molecular technologies since the 1990s for HIV testing. Today, this approach is recommended globally as the single best indicator as to whether a person is taking their HIV medication or not, or whether they have become resistant to their treatment.
“With molecular technologies we can now implement highly centralised, high throughput testing and decentralised, low throughput testing in clinics and hospitals all over the country,” adds Prof. Scott. “This will considerably reduce the money spent on these tests while at the same time advancing, faster, simpler, more accurate testing and diagnostics in the future, potentially for any kind of disease.”
“It’s been a tough, hard road and a huge team effort to get where we are now,” she concludes.
