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Patients being tested for HIV from a mouth swab placed in their mouth can now get their results in just 20 minutes.

Barts and the London NHS Trust is the first organisation in the United Kingdom to run the test which is now being considered for use by other London NHS trusts and has generated interest from overseas healthcare organisations.

The swab test - using a special absorbent toothbrush placed in the gum line - picks up HIV antibody markers from oral fluid. It is referred to as a “point of care” test and removes the need to wait a week for blood test results, reducing anxiety on behalf of patients and enabling clinicians to provide rapid access to further care and treatment where required.

A research study of the test was completed in March 2009 and has been successfully trialled at Ambrose King clinic at The Royal London Hospital, Whitechapel and at Barts Sexual Health Clinic at Barts Hospital in the City of London. Around 200 people at the Trust’s clinics have undergone the test since March and about 250 patients per month are expected to take it in future.

The trial at Barts and The London was part of a large scale research study of 1,500 patients which compared the rapid oral fluid HIV test alongside laboratory-run HIV blood testing.

The study found that the oral fluid point of care test performed comparably to routine HIV serological testing, with 75% of those questioned stating they would prefer an oral fluid test rather than undergoing blood tests. 40% of respondents thought that availability of an oral fluid test would have encouraged them to test for HIV sooner.

Head of Sexual Health Advising at the Trust, Merle Symonds said:

“Patients much prefer this saliva test. The effect of the quick result reduces the anxiety of waiting tremendously. Whereas other clinics do a finger prick test, this oral test is quicker and very popular.

“Approximately a third of people in the UK who are HIV-positive are currently unaware of their condition. There are still very real problems due to people who are not testing until they have become unwell as a result of undiagnosed HIV infection. This means that treatment that is now widely available may not work as effectively.

“Making testing for HIV quicker and easier is a real step towards getting people to test sooner. As this test doesn’t require us to take blood or send samples to a laboratory, we can begin to look towards testing outside traditional clinical areas. We are already offering this test to people in some of our outreach services run in non-healthcare settings.”

The test is currently being offered to all people from areas of high HIV prevalence and to men who have sex with men, in addition to those who are sexually active with either group.

It is important to note that the test picks up HIV antibody markers only in saliva samples from the gum line not the HIV virus itself. So for example, it is not possible to contract the HIV virus from kissing.

Notes

- Barts and The London is one of Britain’s top teaching hospital trusts. Our mission is literally to bring excellence to life - to give patients the best possible care so that they can live better, fuller, longer lives.

- Our world-renowned hospitals - St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel and The London Chest in Bethnal Green - have made and continue to make an outstanding contribution to modern medicine. Read more about our full portfolio of services at http://www.bartsandthelondon.nhs.uk.

- Our £1 billion new hospitals programme is set to transform healthcare facilities locally. When completed the new hospital at The Royal London will be the biggest new hospital in the country, while the new buildings at Barts will house a brand-new cancer hospital and cardiac centre.

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Barts and The London

A recently released AIDS Vaccine Advocacy Coalition report says that although there has been a renewed focus on discovery, innovation and basic science in vaccine research, action is needed to ensure that research funding continues during the economic downturn, VOA News reports. AVAC executive director Mitchell Warren said the report is “about putting all the pieces together … not just the search for an AIDS vaccine, but in fact the entire HIV prevention response.” He added, “[T]he good news is we have some new pieces of the puzzle, and we’re expecting additional new pieces of understanding through research this year.”

Warren said that AVAC believes HIV/AIDS vaccine research is in “one of the most exciting times,” with “new energy, new commitment to unlocking some of the basic scientific roadblocks that have impeded our ability to find a vaccine.” For example, a study released earlier this week examined efforts to produce a vaccine through genetic transfer. Regarding the study, Warren said, “It doesn’t mean we have an AIDS vaccine, but it means we have an entirely new approach to trying to deliver protection.”

Warren said that the field of HIV/AIDS vaccine research has shown a renewed commitment since Merck canceled its vaccine trial in 2007. According to Warren, the new AVAC report examines knowledge gained from the Merck study, which has provided “an unimaginable amount of information.”

Meanwhile, the effect of the economic crisis on research funding is concerning, Warren said, adding, “I believe that every dollar spent is going to be held up to a greater scrutiny as budgets tighten and as funders have to re-examine their priorities.” According to Warren, without renewed funding commitments, “we will not only incur a much greater public health catastrophe, but I would argue that the economic catastrophes to come, if we don’t respond aggressively to HIV, will actually have repercussions that will … make the economic crisis pale in comparison” (DeCapua, VOA News, 5/18).


The report is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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