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CASCADE


HIV/AIDS

Concerted Action on SeroConversion to AIDS and Death in Europe
Framework programme:
5
Project number:
QLK2-CT-2000-01431
EC contribution:
€ 599 994
Duration:
48 months
Type:
CA
Starting date:
1 September 2000
Website:
http://www.ctu.mrc.ac.uk/cascade/

Keywords: HIV; seroconverters; progression; CD4; sub-type; HIV RNA; anti-retroviral therapy; HAART; survival; AIDS

Summary:

The overall aim of this project is to monitor disease progression and survival in both treated and untreated HIV- infected persons by bringing together data from several cohorts in Europe and Australia.  These cohorts only include persons with known or well-estimated dates of HIV seroconversion.

Problem:

Although the clinical course of HIV disease has improved dramatically since the introduction of potent therapies with combinations of anti-HIV drugs, the duration of their effectiveness and the risk of toxicity from prolonged treatment are unknown.  This is largely because the therapies were not available prior to 1996.  Data from persons whose time of HIV infection is known (seroconverters) are uniquely able to examine HIV disease progression throughout the whole period of infection.  Individual cohorts of seroconverters, however, tend to have a relatively small number of subjects or include only one exposure group, for example injecting drug users, homosexual men and haemophiliacs.  This may reduce their ability to address questions about the natural history and clinical course of HIV reliably.

Aim:

The main aim of this proposal is to examine and describe the changes in the clinical course of HIV infection in individuals who are treated, as well as changes in the natural history of those who are untreated. The specific research objectives within this framework are as follows:

  1. To describe temporal changes in time to AIDS and survival – both those which are likely to be due to therapy and those which are likely to be associated with changes in viral characteristics.
  2. To investigate the trends in CD4 cell count and plasma viral load from the time of HIV infection during the whole infection period.
  3. To examine factors which determine disease progression from the time of infection to AIDS, and changes in the spectrum of AIDS-defining events over time.
  4. To monitor disease progression both in persons treated and those untreated at the time of primary infection.
  5. To monitor the time of initiation of therapy and prophylaxis for opportunistic infections in relation to the time since HIV infection.
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