viruses are prone to mutation and newly
emerging strain variants may not be detected by
LFA kits. 7
Another situation where POCT might be
valuable is in the genitourinary medicine setting.
A patient who might not return a week later to be
given a test result regarding a sexually
transmitted infection might be prepared to wait
for an hour. Lateral flow kits are available to
screen for viruses such as hepatitis B (HBV),
hepatitis C (HCV) and HIV, and some formats use
oral fluid instead of blood, which can be more
acceptable. 8 However, there are issues with
sensitivity and this might lead to a protocol that
requires individuals to be screened more
regularly than when using the main laboratory
assays. Also, any patient who is found to be
positive in the POCT test will require further tests
to determine the stage of infection, viral load,
sequence and type of virus in order to inform
treatment and management. 9 Thus it might be
more cost effective to do the initial screening test
and all the follow up work in the main laboratory.
Desk top molecular analysers should be more
accurate than LFAs because they are detecting the
viral genome directly. The range of viruses which
can be detected in molecular POCT is currently
quite limited compared to the multiplex main
laboratory tests and they are more expensive. Also
as mentioned above for the blood borne viruses,
positive results might still require follow up
sequencing and typing for patient management
and epidemiological purposes. However an
interesting innovation is the development of a
low cost analyser capable of monitoring HIV viral
load for use in situations where demand is high,
but resources are limited. 10 Another potential
application of a respiratory POCT is to identify
which patients admitted to hospital with acute
respiratory symptoms have virus i