Dr. Lisa Frenkel’s team is developing a simple test that could
improve HIV treatment and reduce mother-infant transmission.
During the last three decades, Dr. Lisa Frenkel has developed innovative ways to detect HIV, improve treatment for the virus and prevent mother-infant
HIV transmission. One current project is to create an inexpensive, easy-to-use test that quickly identifies drug-resistant HIV so people in the developing
world can get the right medicine the same day they are diagnosed.
Many pregnant patients in the Mozambican clinic where
Dr. Lisa Frenkel studied HIV drug resistance traveled for hours
to get medical care. About 30% of the women had HIV, and
Frenkel knew that – during birthing or breastfeeding – they
would unwittingly expose their infants to the virus. Around
20% of these babies would become HIV-infected, and many
would eventually develop AIDS and die from the disease.
“Pediatric HIV has been nearly eliminated in the U.S.,”
Frenkel says. “Our group is developing practical ways to
make the same progress in the developing world.”
During the last three decades, Frenkel has developed
innovative ways to detect HIV, improve treatment for the
virus and prevent mother-infant HIV transmission. Now her
team is creating the first affordable, easy-to-use test for
drug-resistant HIV strains that affect as many as a third
of infected infants in the developing world.
Being able to quickly identify patients with drug-resistant
HIV lets providers give them the right drugs immediately
to help them survive and to reduce women’s chances of
transmitting HIV during pregnancy, birthing and breastfeeding.
Simplifying a complex test
Dr. Barry Lutz, a bioengineering professor at the University of Washington,
is working to simplify an HIV drug resistance test developed by Dr. Lisa
Frenkel’s team so it can be run quickly and without sophisticated equipment.
While it’s standard practice to test patients for drug-resistant
HIV in developed countries like the U.S., the test
costs upwards of $500, making it cost-prohibitive in the
In the early 1990s, Frenkel’s team developed OLA, a
test for HIV drug resistance. Although OLA costs only about
$3 for the supplies per patient, it includes more than a dozen
complicated steps and takes medical labs about 13 hours to
complete. This creates challenges in the developing world, where many lab technicians don’t have the skills to perform
OLA, and patients often live too far from clinics to come
back for their results.
Last year, the team started re-engineering the test with
help from Drs. Barry Lutz and James Lai at the University
of Washington. Their goal is to keep OLA affordable while
simplifying it until it can be done with basic equipment
and little training.
Detecting HIV more easily
This prototype, developed by Lutz’s team at the UW, turns a complex, five-hour blood analysis test that requires
sophisticated equipment into a simple paper strip test that takes about
30 minutes and can be read by the naked eye.
Lutz has access to some of the world’s most sophisticated
technology, but he has to think like a person who can’t use
any of it. A bioengineering professor, Lutz develops tests
and tools to be used in areas with few resources. He’s
redesigning the part of OLA that analyzes a patient’s blood
sample; it currently involves more than nine steps, takes
more than five hours and requires a sophisticated instrument
to read the results.
Lutz helped develop a blood analysis prototype that
involves three simple steps, takes less than an hour and
can be read by the unaided eye. The key was transforming
it into a paper strip test that technicians dip into a well
containing a patient’s sample and then into chemicals that
detect HIV. Spots appear on the paper and indicate whether
the patient has “wild type” HIV or a drug-resistant strain.
Lutz’s work illustrates how Frenkel’s team is transforming
OLA until it can be performed in rudimentary labs while
“Right now, people get first-line antiretroviral drugs even
if their HIV is resistant to them,” Frenkel says. “Our test
would let you immediately give people the drugs that could
suppress drug-resistant strains and give the patient’s
immune system a chance to recover.”
Tight NIH funding stalls progress
Frenkel and her UW colleagues have recently teamed up
with Epoch Biosciences Inc. to make OLA even simpler
and are looking for funding to translate their prototype
into a test, called OLA-simple, that could be mass-produced.
It could be used in the developing world and as a more
affordable option anywhere.
“Pediatric HIV has been nearly eliminated in the U.S. Our
group is developing practical ways to make the same
progress in the developing world.”
Their recent grant application to the National Institutes of
Health (NIH) scored in the top 7% of applications, but federal
spending cuts have tightened NIH budgets and the team’s
proposal missed the cutoff. Now they are raising a small
amount of money to help prove their concept works so they
can resubmit their NIH grant.
“It’s a tricky funding climate, but that won’t stop us from
bringing OLA-simple to countries where people need it
most,” Frenkel says.
To find out how you can help, email Brenda Majercin or call 206-987-4979.
Published in Connection magazine, November 2013