PROJECT SUMMARY Despite advancements in healthcare, the diagnosis of HIV, HCV and HBV remain poor globally, with a high percentage of undiagnosed and untreated cases. This gap is particularly acute in hard-to-reach populations, leading to increased lifetime costs, lower life expectancy, poorer quality of life and higher rate of transmission. Consequently HIV, HCV and HBV co-infections are a significant cause of mortality and morbidity and place a huge burden on global public health. In fact, of the estimated 38 million people living with HIV in the US and Europe, 4.5 and 3 million, respectively, are estimated to be co-infected with HBV and HCV. It is also known that faster progression of HIV infection in those co-infected with either HBV or HCV, progressively worsening patient prognosis and shortening their life span. Therefore, there is an urgent need for a simultaneous detection platform that can be used at resource-limited settings. Here, we propose to integrate our recently developed technology of an electrochemical biosensor based on four-way junction (4WJ) probes for simultaneous detection of HIV, HCV, and HBV, along with an isothermal amplification (Nucleic Acid Sequence Based Amplification, NASBA) technique that can be used at resource-limited settings. This technology promises to be successful since it is based on a recent development of the PI who showed for the first time that the 4WJ electrochemical biosensor has the capability to detect all HIV subtypes using one single sensor, thus, overcoming the high genome variability of HIV. Virus quantitation is also possible with the 4WJ electrochemical biosensors; thus, enabling monitoring of treatment efficiency.

Project Narrative To end undiagnosed and untreated cases of HIV and Hepatitis co-infections, continuous monitoring of individuals infected is desired. Thus, quantitative detection of virus load to aid treatment must be at the hands of the patient. In this proposal, we will develop a recognition platform for a reliable, cost-effective, and simultaneous molecular detection for all HIV subtypes and HCV and HBV that can be used at resource-limited settings.