Human Immunodeficiency Virus (HIV) and AIDS have taken the lives of 35 million people. However, the development of powerful antiretroviral medication, ground-breaking research and technological evolution are all helping to minimise the impact of these conditions.

World Health Organisation (WHO) figures reveal that Human Immunodeficiency Virus (HIV) and AIDS have taken the lives of 35 million people to date. They have long been considered to be dangerous and fast-moving diseases, that cripple the immune system by attacking healthy cells. However, the development of powerful antiretroviral (ART) medication, ground-breaking research and technological evolution are helping to limit the spread of the disease.

In previous years, a HIV diagnosis usually meant a significantly shorter life expectancy, but advancements in ART medication mean it is now possible to live a near-normal lifespan. In fact, UNAIDS believes that by 2030, AIDS will no longer be a public health threat, raising the prospect of a HIV-free future.  

However, early detection and treatment is key, and this is still a challenge in developing countries that lack infrastructure and access to trained medical professionals. UNAIDS launched the 90-90-90 target in 2014, with the aim that “90% of all HIV-positive persons know their status, 90% of these HIV-positive persons are on ART, and 90% of these people on ART achieve viral suppression.” This describes the point where the virus becomes undetectable and cannot be transmitted, leading to a HIV-free future.

The Brigham and Women’s Hospital in Boston, Massachusetts has designed a portable and affordable mobile phone diagnostic tool capable of detecting HIV viruses in resource-limited regions. Using nanotechnology, a microchip, a mobile phone, and a 3D-printed phone attachment, researchers created a system for diagnosis and for monitoring the management of the condition. The platform can detect the RNA nucleic acids of the virus from a single drop of blood through on-phone monitoring, without the need for additional expensive equipment. The researchers discovered that the platform allowed the detection of HIV with 99.1 per cent specificity.

Hadi Shafiee, PhD, a principal investigator in the Division of Engineering in Medicine and Renal Division of Medicine at the Brigham, and author of the research has commented: "Early detection of HIV is critical to prevent disease progression and transmission, and it requires long-term monitoring, which can be a burden for families that have to travel to reach a clinic or hospital. This rapid and low-cost cell phone system represents a new method for detecting acute infection, which would reduce the risk of virus transmission and could also be used to detect early treatment failure. The team also believe that the technology could be used as a “rapid and low-cost diagnostic for other viruses and bacteria as well.”
In a similar vein, experts at Columbia University developed a dongle that can analyse a drop of blood for the antibodies that fight HIV. The dongle is connected to a smartphone or tablet via its audio jack, then an app analyses the results and is able to produce a diagnosis within 15 minutes. The device replicates all mechanical, optical, and electronic functions of a lab-based blood test. The researchers also ensured the dongle uses low power consumption, so that it’s still effective in areas without continuous access to electricity.

Innovation around the detection of HIV can also manifest itself in very unexpected ways. Researchers at the University of Pennsylvania and Penn Medicine's Social Media and Health Innovation Lab, discovered that studying human behaviour online can help predict disease outbreaks. Analysing behaviour on Twitter has provided insight for epidemiologists, computer scientists and psychologists. Professor Andrew Schwarz says:  "Twitter is a compendium of who we are. The language that we write is a representation of our daily lives. It captures aspects of people that are otherwise quite elusive to health researchers, such as the psychological side that's difficult to get at."  

A big data approach using Twitter and Facebook can provide results much quicker than traditional large-scale surveys. Using sophisticated geocoding techniques to analyse large volumes of Twitter data, researchers can potentially identify areas at higher risk of HIV, enabling the implementation of protective measures before the actual outbreak occurs.

Early detection of communicable diseases like HIV is crucial, especially in developing countries where diseases can spread quickly. Encouragingly, UNAIDS figures reveal more than half of all people living with HIV are medicating with ART, which is a record 19.5 million people. Botswana in Africa is believed to be close to reaching the UN target of 90-90-90 for testing, treatment and viral suppression. This was made possible thanks to the availability of free ART, which provides affected citizens with hope for the future.

While digital innovations are undoubtedly helping with the diagnosis of HIV and helping to prolong life expectancies, raising awareness around the disease remains a critical part of combatting its spread. Prevention is always more powerful than cure.

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