San Francisco Chronicle - Thursday, August 10, 2000
Tom Abate, Chronicle Staff Writer

Calypte Biomedical Corp. of Alameda sells a U.S. government-approved test that uses urine samples to detect AIDS, a practice that health experts say is easier and safer than traditional blood tests.

Calypte has already formed a partnership with a South African firm to put six mobile clinics into the field. Some are buses, and the rest are shipping containers that can be loaded onto a train or truck bed and driven into rural areas where blood tests would be impractical to administer.

Calypte said it has a verbal commitment from an international agency to fund the six South African mobile clinics. The company and its African partner now want to create mobile clinics for other African countries -- provided they can get international support to pay for the urine test, which costs roughly $3 in the United States.

"In the beginning, we and our partners have shouldered the financial burden, but we cannot afford to give the test away," said Calypte business development director Dick Van Maanen.

Tom Coates, director of the AIDS Research Institute at the University of California at San Francisco, said Calypte's effort could find favor with international agencies and philanthropic institutes that are beginning to take the African AIDS crisis seriously.

"Testing is really a good cause, they don't come much better," said Coates, who helped author a recent scientific study that showed the health benefits of testing for AIDS and counseling those who test positive.

"We find that people do change their behavior in ways that can help slow the spread of the epidemic," he said.

Calypte's South African program is designed to offer both testing and counseling, the company said.

In practice, the mobile clinic would pull into a village and ask the village elders to help persuade people to submit urine samples. The mobile clinics have all the equipment needed to analyze the samples and deliver the results, along with some counseling, the next day.

Niel Constantine, director of clinical immunology at the University of Maryland Medical System, said urine testing has many advantages over blood tests.

For one thing, it requires skill to draw a blood sample, he said. Health workers can accidentally prick themselves and contract the virus. Needles are supposed to be destroyed, but in practice, they are reused. And blood collected in the field may spoil if it takes more than a couple of days to reach a lab.

By contrast, he said, a urine sample is easier and safer to collect. Constantine said there is no known way to contract AIDS from urine, because the HIV virus does not inhabit urine. The test detects the presence of the disease by spotting the antibodies that the immune system creates to fight AIDS.

Although the urine test may be the leader for ease of use and practicality in Third World settings, other tests on the horizon promise comparable advantages.

For instance, Constantine said new devices rely on a single finger prick to draw a drop of blood, avoiding the needle issue. The blood is dropped right into the device, which acts like a litmus test to detect AIDS on the spot. But this technology is costly. Constantine said the devices can run up to $7, or as much as twice the cost of other tests.

An Oregon firm called Epitope is close to winning U.S. and European regulatory approval to sell a test that can detect AIDS by rubbing a swab over a person's gums to sample their saliva. Test results would be available within minutes.

"We need all these tests, and not just in the developing countries," Constantine said.

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