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CASCADE
HIV/AIDS
Framework programme: 6
Call: 3
Project number:
LSHP-CT-2006-018949
EC contribution: € 1 700 000
Duration: 48 months
Type: CA
Starting date: 1st March 2006
Graphic element Concerted Action on SeroConversion to AIDS and Death in Europe
Keywords: HIV; seroconverters; observational; survival; AIDS; antiretroviral; incidence

Summary:

CASCADE was established in 1997 as a collaboration between the investigators of 22 cohorts of people with well-estimated dates of HIV seroconversion (seroconverters). It is currently a network of epidemiologists, statisticians, virologists and clinicians from leading HIV institutions in 13 European countries, Australia and Canada. Seroconverters are enrolled into the individual cohorts locally and nationally, and are typically followed up for the whole of life. CASCADE’s main aim is to monitor newly infected individuals and those already enrolled in studies, covering the entire duration of HIV infection. The main premise is that through pooling data issues will be addressed, which cannot be reliably addressed from single studies alone.

Background:

Follow-up data from seroconverters are valuable in being able to relate events to the same timeframe since an individual first became infected with HIV. Seroconverters thus provide a unique opportunity to study HIV throughout its whole infection period and also enable examination of the characteristics of recently acquired HIV infection in the population and changes over time.

 

Aim:

The key objectives are:

  1. to estimate survival expectations and assess changes over time
  2. to assess the impact of adverse drug reactions on survival, particularly if therapy is started close to seroconversion, and monitor changes in the cause of death over time
  3. to examine any changes in the characteristics of the HIV virus over time
  4. to determine the impact of transmitted resistance, virus subtype and host genetic factors on response to therapy and clinical outcome
  5. to characterise the foci of recent HIV epidemics in Eastern Europe
  6. to characterise initial disease progression in new epidemic areas
  7. to examine the effect of co-infection on HIV disease and response to therapy
  8. to develop new techniques to facilitate the coordination of HIV clinical research across European cohorts.

Expected results:

Survival estimates following HIV seroconversion are likely to change in the future as further new treatments and therapeutic strategies are introduced. Inequality in HIV care and newly emerging strains of HIV may also influence disease progression. A priority for CASCADE is to explore ways to ascertain and characterise the foci of recent HIV epidemics in Eastern Europe, and the varying levels of intervention against them. This will help in the understanding of likely future transmission dynamics across the European region.

Because HIV-infected persons are now expected to live longer, it is likely that non AIDS-related causes of death will become increasingly important, particularly as adverse drug reactions might also have an impact. The question of whether co-infections, such as HBV and HCV, accelerate HIV disease progression and vice versa have also yet to be resolved, and CASCADE will provide an ideal opportunity to address this.

It is widely thought that host genetic factors play an important part in determining disease progression. Applying recent advances in the understanding of host genetic influences of HIV infection to the mature CASCADE database will be a timely contribution to this key area of research.

 

Potential applications:

CASCADE has already produced a number of publications addressing questions: How long have I been infected? When should I start treatment? How long will I live for?

The current CASCADE project should: a) contribute to improving the care of HIV-infected persons; b) deepen understanding of the evolving HIV epidemic across Europe; c) improve surveillance of the epidemic; and d) build research capacity in Eastern Europe, as well as develop new biostatistical analytical techniques.

Coordinators:

Kholoud Porter
MRC Clinical Trials Unit
222 Euston Road, NW1 2DA London
Tel: +44 20 7670 4715
Fax: +44 20 7670 4815
E-mail: k.porter@ctu.mrc.ac.uk
Website: http://www.ctu.mrc.ac.uk

Krishnan Bhaskaran
MRC Clinical Trials Unit
222 Euston Road, NW1 2DA London
Tel: +44 20 7670 4730
Fax: +44 20 7670 4815
E-mail: k.bhaskaran@ctu.mrc.ac.uk
Website: http://www.ctu.mrc.ac.uk

Partners:

Principal
Scientific
Participants
Official Address Other Information
2
Geneviève Chêne
ISPED Université Victor Segalen
146 rue Léo Saignat
FR-33076 Bordeaux Cedex
France
Tel: +33 5 57 57 12 57
Fax: +33 5 57 57 11 72
E-mail: Genevieve.Chene@isped.u-bordeaux2.fr
Website: http://www.isped.u-bordeaux2.fr
3
Bernard Masquelier
Département de Virologie et
Immunologie biologique
CHU de Bordeaux
Place Amélie Raba Léon
FR-33076 Bordeaux cedex
France
Tel: +33 5 56 79 55 10
Fax: +33 5 56 79 56 73
E-mail: bernard.masquelier@chu-bordeaux.fr 
4
Ricardo Camacho
Universidade Nova de Lisboa
Instituto de Higiene e Medicina Tropical
Lisbon
Portugal
Tel: +351 21 3650151
Fax: +351 21 3650144
E-mail: ricardocamacho@hegasmoniz.min-saude.pt
Website: http://www.ihmt.unl.pt
5
Giovanni Rezza
Istituto Superiore di Sanita
Viale Regina Elena, 299
IT-00161 Rome
Italy
Tel: +39 06 4938 7213
Fax: +39 06 4938 7210
E-mail: gianni.rezza@iss.it
ebsite: http://www.iss.it
6
Claudia Balotta
University of Milan
Institute of Infectious and Tropical Diseases
‘L. Sacco’ Hospital
Via G.B. Grassi, 74
IT-20157 Milan
Italy
Tel: +39 02 3820 0319
Fax: +39 02 356 6644
E-mail: Claudia.Balotta@unimi.it
7
Julia Del Amo
Universidad Miguel Hernandez
Campus de San Juan. Apartado de correos 18
ES-03550 San Juan, Alicante
Spain
Tel: +34 96 591 9331
Fax: +34 96 591 9551
E-mail: jamo@umh.es
Website: http://www.umh.es
8
Osamah Hamouda
Robert Koch-Institut
Stresemannstr 90-102
DE-10963 Berlin
Germany
Tel: +49 30 4547 3420
Fax: +49 30 4547 3511
E-mail: HamoudaO@rki.de
Website: http://www.rki.de
9
Oddbjorn Brubakk
Department of Infectious Diseases
Ulleval University Hospital
NO-0407 Oslo
Norway
Tel: +47 22 119272
Fax: +47 22 119181
E-mail: oddbjorn.brubakk@uus.no
10
Giota Touloumi
National and Kapodistrian University of Athens
75 M. Asias str.
Athens
Greece
Tel: +30 210 746 2089
Fax: +30 210 746 2205
E-mail: gtouloum@med.uoa.gr
Website: http://www.uoa.gr
 
11
Patrick Francioli
Centre Hospitalier Universitaire Vaudois
Bugnon 46
Lausanne
Switzerland
Tel: +41 21 314 0250
Fax: +41 21 314 0266
E-mail: patrick.francioli@chuv.ch
Website: http://www.shcs.ch
12
Valerie Delpech
Health Protection Agency Centre for Infections
61 Colindale Avenue
UK-NW9 5EQ London
United Kingdom
Tel: +44 20 8200 6868
Fax: +44 20 8200 7868
E-mail: Valerie.Delpech@HPA.org.uk
Website: http://www.hpa.org.uk
13
Harold Jaffe
University of Oxford
Department of Public Health and Primary Health Care
Old Road Campus, Headington
UK-OX3 7LF Oxford
United Kingdom
Tel: +44 1865 226603
Fax: +44 1865 226720
E-mail: Harold.Jaffe@dphpc.ox.ac.uk
Website: http://www.ox.ac.uk
14
Laurence Meyer
INSERM U569
82 rue du Général Leclerc
Le Kremlin Bicêtre cedex
France
Tel: +33 1 45 21 23 34
Fax: +33 1 45 21 20 75
E-mail: meyer@vjf.inserm.fr
Website: http://www.inserm.fr
15
Philippe Vanhems
INSERM 271
Université Claude Bernard Lyon
8, avenue Rockefeller
Lyon
France
Tel: +33 4 78 77 70 31
Fax: +33 4 78 00 93 86
E-mail: philipva@lyon-sud.univ.Lyon1.fr
16
Court Pedersen
Odense University Hospital
Sdr. Boulevard 29
Odense
Denmark
Tel: +45 65 411816
Fax: +45 66 117418
E-mail: court.pedersen@ouh.fyns-amt.dk
Website: http://www.ouh.dk
17
Maria Prins
Municipal Health Service
Nieuwe Achtergracht 100
PO Box 2200
Amsterdam
Netherlands
Tel: +31 20 555 5243
Fax: +31 20 555 55 3
E-mail: mprins@ggd.amsterdam.nl
Website: http://www.ggd.amsterdam.nl
18
Deenan Pillay
Centre for Virology
Royal Free and University College Medical School
Windeyer Institute
46 Cleveland Street
UK-W1T 4JF London
United Kingdom
Tel: +44 20 7679 9490
Fax: +44 20 7580 5896
E-mail: d.pillay@ucl.ac.uk
Website: http://www.ucl.ac.uk/medicalschool/
19
Caroline Sabin
Department of Primary Care & Population Sciences
Royal Free and University College
Medical School
Rowland Hill Street
UK-NW3 2PF London
United Kingdom
Tel: +44 20 7830 2239
Fax: +44 20 7794 1224
E-mail: c.sabin@pcps.ucl.ac.uk
Website: http://www.ucl.ac.uk/pcps
20
Claus Nielsen
Statens Serum Institut
Artillerivej 5
DK-2300 Copenhagen S
Denmark
Tel: +45 32 683280
Fax: +45 32 683082
E-mail: CN@ssi.dk
Website: http://www.ssi.dk
21
Irja Lutsar
University of Tartu
Institute of Microbiology
Ravila 19
Tartu
Estonia
Tel: +372 7347100
Fax: +372 7374172
E-mail: irja.lutsar@ut.ee
Website: http://www.ut.ee
22
Magdalena Rosinska
National Institute of Hygiene
Chocimska 24
Warsaw
Poland
Tel: +48 22 5421 206
Fax: +48 22 5421 327
E-mail: mrosinska@pzh.gov.pl
Website: http://www.pzh.gov.pl
23
Marek Beniowski
Medical University of Silesia
Clinical Department of Infectious Diseases
Zjednoczenia 10
41-500 Chorzow
Katowice
Poland
Tel: +48 32 3499 341
Fax: +48 32 2417 192
E-mail: hivhepar@gazeta.pl
24
Tatyana Smolskaya
North-West District AIDS Centre
14 Mira Street
St Petersburg
Russian Federation
Tel: +7 812 233 8652
Fax: +7 812 233 0847
E-mail: smolskaya@ts2981.spb.edu
25
Dominique Costagliola
INSERM U720
PO Box BP 335
56 bd Vincent Auriol
Paris
France
Tel: +33 1 42 16 42 82
Fax: +33 1 42 16 42 61
E-mail: dcostagliola@ccde.chups.jussieu.fr
Website: http://www.inserm.fr
26
Dorothy Bray
ImmunoClin Ltd
Rowlandson House
289-293 Ballards Lane
UK-N12 8NP London
United Kingdom
Tel: +44 1494 565545
Fax: +44 1494 565545
E-mail: j.d.bray@btinternet.com
Website: http://www.immunoclin.com
27
Ruslan Malyuta
Perinatal Prevention of AIDS Initiative
4, Moukachevsky loane, Office 15
Odessa 65000
Ukraine
Tel: +380 48 222 7053
Fax: +380 48 222 7053
28
John Gill
Suite 213 906 8th Avenue SW
Calgary
Alberta T2P 1H9
Canada
Tel: +1 403 234 2377
Fax: +1 403 262 4893
E-mail: John.Gill@calgaryhealthregion.ca
29
John Kaldor
National Centre in HIV Epidemiology and Clinical Research
St. Vincent’s Hospital Medical Centre
376 Victoria Street
Darlinghurst.
New South Wales 2010
Australia
Tel: +61 2 9332 4648
Fax: +61 2 9332 1837
E-mail: Jkaldor@nchecr.unsw.edu.au

 
 
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