Integrated electrochemical device to screen for liver function at the point-of-care
Moed, Saundria M.
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Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) continue to be a significant global burden, disproportionately affecting low- and middle-income countries (LMICs). While much progress has been made in treating these epidemics, this has led to a rise in liver complications, as patients on anti-retroviral therapies (to treat HIV) and anti-TBs (to treat TB) are at an increased risk of drug-induced liver injury (DILI). Therefore, patients on these medicines require consistent screening of liver function. But, due to logistical barriers, gold standard DILI screening fails to be executed at the point-of-care (POC) in LMICs. This thesis aims to fill a current and critical void in diagnosis and management of liver diseases in patients with HIV/AIDS and TB in these settings where conventional diagnostic approaches are prohibitively expensive. To address this gap in technology and patient care, we have developed and optimized a robust, novel assay for on-site POC monitoring of liver health. We take an electrochemical approach to quantify the levels of alanine aminotransferase, a key biomarker of liver function, from whole blood samples. Additionally, we build a patient- and provider-centric platform for detection, aiming to minimize sample preparation steps and simplify the user experience. Furthermore, we use a computational approach to explore the impact of our technology at the POC in LMICs, quantifying both the efficacy and cost-effectiveness. Using this technology, health care providers can assess patient liver health at the POC and make clinical decisions in real time. In the field this technology has the potential to impact HIV and TB patient treatment and improve patient quality of life.