New Technique Can Efficiently Detect All Known Human Viruses in a Blood Sample

Physician-scientist here. Current recs from the American Academy of Pediatrics is for both males and females to be immunized for HPV prior to initiation of sexual activity (1). Initially I do believe that the recommendation was only for girls but that has changed for two major reasons: increase herd immunity in the overall population and because men can also get malignancies and lesions from HPV. Of note, the vaccine does not prevent all HPV infections. The 4-valent vaccine covers the two most common cancer-causing HPV strains as well as two others that commonly cause warts.

As for whether a test like this would be useful in clinical practice, it would definitely depend on the situation. HPV is extremely prevalent ... by the time a person has been sexually active for a few years, it is almost guaranteed that they carry at least one strain of HPV (there are about 40-50 strains last I checked). However, most people never have any problems related to HPV, either because their immune system effectively suppresses the virus or because they have a strain that does not cause symptoms.

Is it useful for one to know that they carry a non-malignancy forming, non-lesion causing strain of HPV? Is it useful for 50% of the population to believe that they have an STI although it will likely never cause any clinical symptoms in themselves or any sexual partners? I would say probably not. Is it useful to type the HPV strains of all infected patients? Maybe. Currently it would not be useful as we do not have effective antiviral therapies for HPV. However, understanding the epidemiology more clearly could certainly help as we decide which viruses to attempt to target therapeutically in the future.

I will say this: the test described in this article would generally be described as a "fishing expedition" in the lab where I did my graduate studies. These types of studies can be very useful in certain cases but I predict they may also cause a lot of confusion as we begin to find subclinical viral processes occurring in plenty of healthy people. As a society, we will have to change our perception of what it means to be "infected" with a virus and as a clinician, it may become more challenging to reassure patients that they are healthy (gut and skin microbiome data will likely create a similar predicament with regard to bacteria).

In any case, I'm sorry to hear about your difficulties with HPV. I see patients dealing with it on a fairly regular basis and it can be a frustrating situation. I do hope that there are effective therapies on the horizon.

1. https://www2.aap.org/immunization/illnesses/hpv/hpv.html

I had the same problems getting testing done (sidenote: I want to explode when a medical institution won't provide a test like this to me, even if I'm paying cash, without a doctor's order).

I skipped the testing and paid the vaccine fee out of pocket (I'm a 32 year old male), and was provided the vaccine at Planned Parenthood.

1. People don't trust machines

2. No software company wants to deal with the liability issues

An example of a place where technology takes over a large part of the diagnostic process is prescription glasses. Even then, after measuring your absolute dioptres, a human asks you to try a few combinations to find the most comfortable variant.

They needed to do 17 samples at a time to be financially viable. I suspect it's even worse than that and it's just cheaper if you already know what you're looking for and do it the normal way.

Three letters: F D A.

Do you mean: "Why won't this eventually be available on a drugstore counter so I can diagnose myself?"

The FDA's response for decades is this: you don't have a lab to perform a more detailed confirmation (because false positives sometimes do happen), and you have no doctor or counselor to be there with you when you get the results.

I worked for a biotech firm that had an instant HIV test available a long long time ago. It was deemed too irresponsible to let people to check themselves at home because the company (and the FDA, and everyone's lawyers) were afraid of people doing rash things after a positive result. If a false-positive HIV patient killed themselves and the family sues, that would be...bad.

Even today, the home-HIV test that's on the market involves you sending in the sample and then getting a phone call with the results.

It's a research tool now, just needs an entrepreneur to make one that can be commercialized. Certainly that is the next step..

Allow me a flippant response, "nothing." Looking at some of the papers that W. Ian Lipkin has published he's been working on this for a while.

So as a researcher he provides data which the FDA will use to assess accuracy and viability, meanwhile Columbia will probably lease out the patents (https://patentimages.storage.googleapis.com/pdfs/US200600033...) when it issues to a diagnostics company, perhaps to Elizabeth Holmes company (http://www.wired.com/2014/02/elizabeth-holmes-theranos/) who will then create a cost effective way to put this into drug stores everywhere, and when you're feeling bad you go in, prick your thumb, and get a text message of everything you might be sick with.

This also might be a problem--we may begin finding out that more people carry benign viral infections than we previously thought (ie, subclinical carriers). The more fishing expeditions that we conduct, as opposed to specific viral tests, the more questions we may have about the definition of "clean" blood.

Agreed. Same with cold virus vs. atypical pneumonia. I've actually been trying to figure out how this could be done for quite a while because it could save a TON of healthcare dollars, sick days, etc.

The paper only talks about virus detection, not bacteria. It does seem to benefit from being able to tell you exactly which genome you have.

"Ian Lipkin, a virus hunter from Columbia University"

It's a research paper at this point. Pricing comes after FDA approval and the ability to scale. The article says it is financially viable if there are 21 patient scans done per batch. If an additional breakthrough allows more than 21 patients per batch, then end-user pricing can fall.