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Swiss HIV Cohort Study (SHCS)

English title Swiss HIV Cohort Study (SHCS)
Applicant Günthard Huldrych Fritz
Number 148522
Funding scheme Cohort Studies Large
Research institution Klinik für Infektionskrankheiten und Spitalhygiene Universitätsspital Zürich
Institution of higher education University of Zurich - ZH
Main discipline Internal Medicine
Start/End 01.01.2014 - 31.12.2017
Approved amount 10'528'000.00
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All Disciplines (23)

Discipline
Internal Medicine
Neurology, Psychiatry
Gynaecology
Clinical Cardiovascular Research
Clinical Cancer Research
Clinical Immunology and Immunopathology
Clinical Pharmacology
Infectious Diseases
Cellular Biology, Cytology
Pharmacology, Pharmacy
Medical Microbiology
Cancer
Methods of Epidemiology and Preventive Medicine
Immunology, Immunopathology
Clinical Endocrinology
Clinical Pathophysiology
Medical Statistics
Medico-Social Problems of Youth
Ethology
Genetics
Addictive Diseases
Molecular Biology
Experimental Microbiology

Keywords (8)

Immune deficiency; Antiretroviral therapy; HIV; drug resistance; side effects; toxicity; virus host interactions; hiv epidemic

Lay Summary (German)

Lead
Die Schweizerische HIV Kohortenstudie (www.shcs.ch) ist eine klinische, multizentrische Langzeit-Studie, die HIV infizierte Menschen einschliesst. Sie forscht im Bereich der HIV-Medizin, der Grundlagen-, der Sozialen und Präventiven Wissenschaften. Sie wurde 1988 begonnen, schliesst bisher ~19000 PatientInnen ein. Sie ist entscheidend für die hohe Qualität der HIV-Medizin in der Schweiz und für das bessere Verständnis der Wechselwirkung zwischen dem HI-Virus und dem menschlichen Organismus.
Lay summary
Die Schweizerische HIV Kohortenstudie (SHCS) wurde 1988 gestartet. Seither wurden ~19000 PatientInnen eingeschlossen und 2013 wurden beinahe 9000 aktiv betreut. 2003 wurde die Swiss Mother and Child HIV Cohort Study (MoCHIV) in die SHCS integriert. Schon früh vereinte die SHCS klinisch, translational, grundlagen- und sozial wissenschaftlich ausgerichtete Forschende. Bisher sind mehr als 700 in Fachzeitschriften erschienene wissenschaftliche Artikel aus der SHCS hervorgegangen, was deren Bedeutung unterstreicht. Eine ihrer Besonderheiten ist, dass sie jeweils rasch auf neue wissenschaftliche Erkenntnisse und Herausforderungen im Bereich der HIV-Forschung reagierte. Die SHCS ist repräsentativ für die Schweiz: mindestens 45% aller HIV-Infizierten, 75% aller PatientInnen mit AIDS und 75% aller Individuen in der Schweiz die antiretroviral behandelt werden nehmen an der Studie teil. Sie ist entscheidend für die hohe HIV-Behandlungsqualität in der Schweiz und leistet einen entscheidenden Beitrag zur Verhinderung von Neuinfektionen. Sie studiert medikamentöse Langzeitnebenwirkungen, Uebertragung von HIV, Koinfektionen und Resistenz, optimiert die antiretrovirale Therapie, bekämpft die Uebertragung von HIV von der Mutter auf das Kind und erforscht die Wechselwirkung zwischen dem HI Virus und dem menschlichen Organismus intensiv. Insbesondere laufen Studien, die letztlich auf die Entwicklung von Impfungen hinauslaufen und die verstehen helfen, warum es bisher nicht gelingt HIV zu heilen. Sozialwissenschaftliche Projekte laufen, um die Auswirkungen der HIV Infektion auf die Psyche und die Beschäftigungssituation zu verstehen. Zusammenfassend stellt die SHCS ein modernes Forschungsinstrument dar, das direkt den PatientInnen zu Gute kommt, einen grossen Beitrag zur Eindämmung der HIV-Epidemie in der Schweiz leistet und hilft, die Biologie der HIV Infektion im Menschen besser zu verstehen, was die Voraussetzung ist für eine wirksame Impfung oder eine Heilung.  
Direct link to Lay Summary Last update: 03.12.2013

Lay Summary (English)

Lead
The Swiss HIV Cohort Study (www.shcs.ch) is a multicenter, clinic based longitudinal study enrolling HIV infected individuals in Switzerland. It aims at performing research in the field of HIV medicine, basic and social sciences and public health. It started 1988, includes ~19000 patients, is instrumental for the high quality of HIV-care in Switzerland, for monitoring the HIV epidemic and co-infections, and has contributed to better understanding interactions between HIV and the human host.
Lay summary
The SHCS is a fully established cohort that was started in 1988. Since then, ~19000  patients were enrolled and in 2013, almost 9000 were followed actively. From the beginning, the SHCS was an open, longitudinal cohort, enrolling continuously individuals from all transmission groups. In 2003 the “Swiss Mother and Child HIV Cohort Study” (MoCHiV) was integrated into the SHCS. Early on, the SHCS unified clinical, translational, basic, social and epidemiological science, as well more recently also nursing research. The considerable scientific impact of the SHCS and MoCHiV is illustrated by more than 700 publications in peer reviewed journals that directly emerged from these studies, respectively were made possible by significant contributions of the SHCS. One of the hallmarks of the SHCS is that this research network was able to rapidly respond to new scientific findings and challenges in the field. The SHCS is nationwide highly representative. At least 45% of all HIV-infected individuals living in Switzerland, 75% of all patients with AIDS and 75% of all patients on antiretroviral treatment participate in the SHCS. The SHCS has a strong impact on public health in Switzerland and includes: (i) Providing high quality data on HIV transmission, (ii) preventing HIV-transmission by optimal treatment and counseling, (iii) informing care givers on optimal screening and treatment interventions, (iv) providing key data on how to prevent and treat opportunistic infections, (v) monitoring co-infections and other  sexually transmitted infections (STI), (vi) providing behavioral data on sexual activities, on prevention measures, substance abuse, depression prevalence, employment status, and activities of daily living, (vii) performing cost effectiveness studies with regard to diagnostic procedures, (viii) monitoring transmission of HIV drug resistance, (ix) continuously delivering high quality data for prevention campaigns, (x) providing feedback to physicians on treatment outcome and mortality compared to other settings. 
Direct link to Lay Summary Last update: 03.12.2013

Responsible applicant and co-applicants

Name Institute

Employees

Associated projects

Number Title Start Funding scheme
120793 Minority quasispecies of drug-resistant HIV-1: Emergence, transmission, dynamics, and clinical relevance in acute and chronic HIV-1 infection 01.11.2008 Project funding (special)
135745 ER Niacin/laropiprant impact on cardiovascular markers and atheroprogression in HIV-infected individuals on cART: the NILACH trial 01.01.2012 Project funding (special)
114006 Monotherapy in Switzerland and Thailand (MOST-cohort) 01.10.2006 Project funding (special)
163348 Longitudinal Neurocognitive Assessment in the Metabolic and Aging Cohort of the Swiss HIV Cohort Study: the NAMACO study 01.01.2016 Project funding (special)
177499 Swiss HIV Cohort Study (SHCS) 01.01.2018 Cohort Studies Large
103560 Cost-effectiveness of genotypic and phenotypic antiretroviral resistance testing in HIV infected patients 01.07.2004 Project funding (special)
112655 Managing variability in HIV therapy: integration of pharmacogenetics, pharmacokinetics and pharmacodynamics of antiretroviral drugs 01.04.2006 Project funding (special)
131629 Long-term antiretroviral therapy of HIV-infected patients in sub-Saharan Africa - insights from causal and mathematical modelling 01.01.2011 Ambizione
146331 HIV-1 whole-genome quasispecies analysis in longitudinal clinical samples 01.04.2013 Interdisciplinary projects
108787 Swiss HIV Cohort Study 01.04.2006 Cohort Studies Large
146143 Understanding and Predicting the Hepatitis C Epidemic in HIV-infected Patients 01.05.2013 Project funding (special)
110012 Host genetic and genomic determinants of susceptibility to HIV-1 01.11.2005 Project funding (Div. I-III)
125441 Molecular and clinical epidemiology of tuberculosis in Switzerland: Studies of populations infected and not infected with HIV 01.04.2009 Project funding (special)
159868 HIV-1 Transmission in Switzerland: viral transmission traits, superinfection and drug resistance 01.05.2015 Project funding (special)
173061 Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: an international, prospective, multi-centre cross-sectional study 01.04.2017 Project funding (Div. I-III)
141067 HIV-1 integration sites and their impact on HIV-1 pathogenesis 01.04.2012 Project funding (Div. I-III)
142411 Combining molecular epidemiology approaches and mathematical models for the spread of HIV and its coinfections 01.10.2012 Ambizione
136820 Estimating epidemiological and evolutionary parameters from viral sequence data using phylogenetic methods 01.01.2012 Ambizione
116862 Impact of HIV and antiretroviral therapy on Hepatitis C virus (HCV) evolution and on HCV-specific cellular immunity 01.06.2007 Project funding (special)
112594 HIV-1 drug resistance in the swiss HIV cohort study: epidemiology and impact on the management of HIV infected patients 01.05.2006 Project funding (special)
136737 Acute and chronic dynamics of HIV and HCV infections, within-host evolution and epidemiological outcomes 01.10.2011 Ambizione
103748 Humoral immunity to HIV-1: Analysis of the function of antibody responses as correlate and surrogate marker of viremia control 01.04.2004 Project funding (Div. I-III)
116035 Factors associated with viral control after primary HIV-1 infection and viral determinants associated with HIV-1 transmission 01.04.2007 Project funding (special)
124943 Pharmacocinétique de population, pharmacogénétique, et profils métaboliques de la thérapie anti-HIV 01.04.2009 Project funding (special)
144209 Dynamics of atherosclerosis progression in HIV-infected and HIV-uninfected persons - a longitudinal study using coronary computed tomography angiography 01.07.2013 Project funding (special)
127017 HIV-1 whole-genome quasispecies analysis by ultra-deep sequencing and computational haplotype inference to determine the mechanisms of drug resistance development 01.01.2010 Interdisciplinary projects
134277 Swiss HIV Cohort Study (SHCS) 01.01.2011 Cohort Studies Large
132863 Host evolutionary genomics of HIV-1 and other retroviruses 01.11.2010 Project funding (Div. I-III)
130865 HIV-1 Transmission in Switzerland: Long term-molecular epidemiology and biological properties of transmitted viruses 01.11.2010 Project funding (special)
141234 Pharmacologie clinique et pharmacogénétique de la prise en charge complexe des sujets infectés par HIV ou co-infectés par HIV et HCV 01.04.2012 Project funding (special)
65168 Analysis of the correlates of protection in structured intermittent therapy: An in vivo model of acute HIV infection? 01.10.2001 Project funding (special)
127631 Contribution of multiple genetic variants, identified in genome-wide association studies, to coronary artery disease in HIV-infected individuals 01.12.2009 Project funding (special)
142403 Relevance of different CD4+ T-cell subsets for antifungal defense. What is aberrant in immunocompromised patients? 01.01.2013 Ambizione

Abstract

The Swiss HIV Cohort Study (SHCS), established in 1988, is an ongoing, longitudinal, clinic-based cohort of HIV-1 infected adults. Until to date, cumulatively, 17'795 persons have been enrolled. The strength of the cohort is the comprehensive collection of clinical, laboratory and socio-demographic data as well as biological samples from enrolled individuals every 3 - 6 months accompanied by a strict quality control program. The size and duration of the cohort allowed for the formation of a world-wide exceptional biobank which currently contains > 1.3 mio specimens from HIV infected individuals and thereby provides a unique research platform for clinical, translational, epidemiological, social and basic research worldwide. Due to its continuing success in recruiting patients, the SHCS is representative of the Swiss HIV-1 infected population. Likewise, due to its longevity, comprehensive and high quality data collection, the SHCS will continue to provide invaluable data for public health as best evidenced by the major impact on the high quality of HIV care the SHCS has had in Switzerland. An important reason for this success remains that all key players in Swiss HIV medicine are participating in the SHCS which guarantees that research results are rapidly transformed into clinical care. With its drug resistance database containing > 19000 pol genotypes and its host genetic database of > 2500 whole human genomes, the SHCS is in a position to actively contribute to large international collaborations to resolve research questions that cannot be resolved by single cohorts. Key to success of the SHCS are also two further important factors, the clear dedication to a multidisciplinary approach which promotes crossing of conventional research areas and the system of nested research projects that allows to rapidly respond to the needs of the continuously changing HIV epidemic.
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