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When asked why she is interested in global health work abroad, Dr. Lisa Frenkel simply answers, “Because that’s where the need is.” This sentiment seems to reflect Dr. Frenkel’s career trajectory as well. As a pediatric infectious disease fellow at UCLA in the 80s, she began her career primarily looking at herpes simplex. However, with the advent of the HIV/AIDS outbreak, she encountered many male patients with shingles who later tested positive for HIV and NICU infants who tested positive for HIV. Dr. Frenkel’s research interests thus shifted. Her partnership with TREE began after she crossed paths with Dr. Michael Chung, director of TREE, in UW pediatrics, and she has worked on two projects concerning drug resistance with TREE in the past.
Currently, Oligonucleotide Ligation Assay (OLA) testing is Dr. Frenkel’s third TREE collaboration. The assay looks at specific codons in the HIV genome, the mutations of which would lead to failure of certain Antiretroviral Therapies (ART). Drug resistance is especially problematic as it leads to virologic failure and may subsequently be transmitted to others. As a result, in the worldwide battle against HIV/AIDS today where precautions against drug resistance are not universally taken, Dr. Frenkel highly emphasizes the need for proper testing to guide antiretroviral drug administration. While she mainly operates out of her office in Seattle Children’s Research Institute, Dr. Frenkel coordinates projects around the world.
The utilization of OLA has already been attempted in several countries, and she notes that one of the biggest challenges in adapting this assay is the lower level of knowledge and/or expertise in laboratories abroad. In consequence, due to the complexity of the assay and the need for precision, the end goal is to simplify it and reduce the chance of mistakes between steps. The ideal product, Dr. Frenkel describes, would be to create a point-of-care test, an assay which can be performed with limited equipment; for example, a pregnancy test. While OLA may never be quite as simple as a pregnancy test, due to inherent characteristics of detecting resistance, improvements in packaging the assay are on the way. Outside the lab, Dr. Frenkel finds time to hike, read, and sometimes takes trips to countries where she has ongoing projects.