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CASCADE Virology


HIV/AIDS

Virological Characterisation of Primary HIV Infection in the Concerted Action on SeroConversion to AIDS and Death in Europe
Framework programme:
5
Project number:
QLK2-CT-2002-01708
EC contribution:
€ 528 240
Duration:
24 months
Type:
CA
Starting date:
September 2002

Keywords: HIV; seroconverters; primary resistance; key mutations; progression; CD4; subtype; HIV RNA; HAART; survival

Summary:

The overall aim of this project is to study the virological characteristics of new HIV-1 infections from around Europe. The project will focus on the HIV-1 subtypes, which are a reflection of the worldwide geographical origin of infections, and the presence of drug resistant strains, which, if present in primary infection, represent transmission of drug resistant virus. A number of cohorts of persons with known dates of HIV seroconversion (seroconverters) enrolled within the CASCADE will be utilised.

Problem:

CASCADE has described the lack of change in the AIDS incubation period and survival in Europe prior to the introduction of potent anti-retroviral therapy combinations in the mid-1990s. The clinical course of HIV disease has improved dramatically since the introduction of highly active anti-retroviral therapy (HAART) and CASCADE has been able to quantify such change by providing estimates of the current survival expectations. However, the number of new infections within Europe continues to rise. The unfolding of the epidemic during this period has been characterised by two key virological parameters, which have potential bearing on the incubation period and survival in seroconverter cohorts. Firstly, the emergence of drug resistance in treated individuals has led to the transmission of resistant virus strains. Secondly, the ongoing migratory patterns into,and within Europe has been associated with the introduction of a wider variety of HIV-1 subtypes then had previously existed. One of the main characteristics of HIV is its extensive genetic diversity. The major group circulating globally is M, which can be divided into a number of subtypes, based on genomic relatedness. These subtypes (A-K), as well as 11 recombinant forms, are geographically distributed, and therefore represent a marker of migration. It is expected that these diverse viruses will be further spread within Europe by the ongoing epidemic.

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