The changing pattern of “smart” flow cytometry (S‐FC) to assist the cost‐effective diagnosis of HIV, tuberculosis, and leukemias in resource‐restricted conditions

Abstract

This year is the 25 th anniversary of the identification of HIV and the editorial team would like to dedicate this month's News and EFIS to a reflection on HIV. First, Deborah Jack, the Chief Executive at the National AIDS Trust in the UK, highlights World AIDS Day 2007 and the need to communicate efficiently to fight against HIV. Second, Sarah Rowland-Jones, an expert in HIV research, gives us an overview of the recent advances in HIV immunology, indicating how these may contribute to the design of a successful vaccine and underlining the difficulties in developing a promising candidate.

Laboratory Diagnosis of Tuberculosis in Resource-Poor Countries: Challenges and Opportunities

“…With the demand to carry out CD4 assays on the multitudes of individuals requiring antiretroviral therapy, many efforts have been made to develop simple, cost-effective, quality-assured, sustainable, and industry-supported flow cytometry apparatuses and tests, referred to as "smart flow cytometry" (S-FC). S-FC has been successfully introduced in "resource-restricted" countries in Africa and the Caribbean for CD4 ϩ T cell counting for patients with HIV/ AIDS (76). Recently, S-FC has also been demonstrated to be compatible with antigen-specific cellular immune response assays that can help to rapidly diagnose active TB in both HIVnegative and HIV-TB-coinfected individuals.…”

Achieving STOP TB Partnership goals: perspectives on development of new diagnostics, drugs and vaccines for tuberculosis

“…Translation of new tools to POC requires a better understanding of barriers to implementation. For example, two decades, a large investment has gone into developing appropriate low‐cost CD4 count testing for patients on antiretroviral therapy (ART) in Africa (Janossy 2008). Despite these attempts at developing a point of care tool, CD4 counting remains restricted to centralised services and not POC (Maclennan et al.…”

A model for continuous quality control incorporating sample‐to‐sample assessment of optical alignment, fluorescence sensitivity, and volumetric operation of flow cytometers

“…Nonmechanical factors had no significant impact on either BCR, absolute CD4 count, stability histograms (TVF and TVC) or the corresponding FPCV values. These included protocol selection, changing discriminator settings within reasonable limits (absolute CD4 counts CV of 2.11% and BCR CV of 3.14%, P > 0.05), using different cellular gating strategies (CD45 bright gating with CD3/4þ or PLG CD4 gating; %CV values of 4.79 and 4.95%, respectively; P > 0.05) or using different bead gating strategies (FSC vs C also did not affect BCR significantly (18)(19)(20)(21)(22) C; P > 0.05 for BCR and absolute CD4 counts). Sample flow rate (data not shown).…”

“…Flow cytometry was established as the method of choice for CD4 T-cell enumeration during the 1990s (14)(15)(16). With the advent of the HIV pandemic, CD4 T-cell methods were adapted to identify patients qualifying for antiretroviral therapy (ART) and monitor their response through absolute CD4 counting (17)(18)(19)(20)(21)(22)(23)(24). However, the number of HIV infected individuals in Sub-Saharan Africa (with particular reference to South Africa) (25) continues to increase largely due to paucity of accessible and clinically useful vaccines.…”