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CASCADE
HIV/AIDS
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/
Graphic element Concerted Action on SeroConversion to AIDS and Death in Europe
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.

Expected results:

  • Report on changes in disease progression rates in treated and untreated individuals over time.
  • Report on trends in laboratory markers over the period from seroconversion to death.
  • Report on changes in the time from seroconversion to specific AIDS diseases.
  • Report on clinical outcome from presentation at primary infection and the effect of therapy.
  • Report on the time to initiation of anti-HIV therapy and prophylaxis for opportunistic infection.
  • Report on differences in HIV progression by HIV sub-type.
  • Distribution of HIV-1 subtypes for heterosexually infected individuals.

Potential applications:

Results from this study will provide clinicians with valuable information for the clinical management of their patients, such as factors that are likely to be associated with response to anti-HIV therapies and clinical outcome.

Data from these cohorts are needed to produce new survival estimates for HIV infected individuals.  Such estimates are important to assess the impact of new treatments, to predict the future course of the epidemic, to counsel HIV-infected individuals and for modelling the underlying transmission of HIV infection.

Coordinators:

Janet Darbyshire
MRC Clinical Trials Unit
222 Euston Road
NW1 2DA London
United Kingdom
Tel: +44 20 7670 4702
Fax: +44 20 7670 4815
E-mail: j.darbyshire@ctu.mrc.ac.uk
Website: http://www.ctu.mrc.ac.uk

Kholoud Porter
MRC Clinical Trials Unit
222 Euston Road
NW1 2DA London
United Kingdom
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

Partners:

Principal
Scientific
Participants
Official Address Other Information
3Roel A CoutinhoMunicipal Health Service
Department of Public Health and Environment
PO Box 2200
NL-1000 CE Amsterdam
The Netherlands
Tel: +31 20 555 5223
Fax: +31 20 555 5533
E-mail: rcoutinho@gggd.amsterdam.nl
Website: http://www.gggd.amsterdam.nl/
4Ildefonso Hernández AguadoCatedrático de Medicina Preventiva y Salud Pública
Departamento de Salud Pública
Campus de San Juan
Facultad de Medicina
Carretera de Valencia s/n
ES-03550 San Juan de Alicante
Spain
Tel: +34 96 5919512
Fax: +34 96 5919551
E-mail: ihernandez@umh.es
Website: http://www.umh.es/
5Court PedersenOdense University Hospital
Medical Department C
Sdr. Boulevard 29
DK-5000 Odense
Denmark
Tel: +45 65 411816
Fax: +45 66 117418
E-mail: courtpedersen@dadl.dk
Website: http://www.ouh.dk/
6Giota TouloumiHellenic Scientific Society for AIDS and STDs
PO Box 14010, 5 Dragoumi Str
EL-16121 Athens
Greece
Tel: +30 1 07462089
Fax: +30 1 7462080
E-mail: gtouloum@atlas.uoa.gr
7Anne EskildNational Institute of Public Health
Department of Epidemiology
Geitmyrsvn 75
NO - 0462 Oslo
Norway
Tel: +47 22 042393
Fax: +47 22 042351
E-mail: anne.eskild@folkehelsa.no
Website: http://www.folkehelsa.no/
8Laurence MeyerService d'épidémiologie - INSERM U292
Hôpital de Bicêtre
82 rue du Général Leclerc
FR-94276 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://ifr69.vjf.inserm.fr/~web292/
9Giovanni RezzaIstituto Superiore di Sanita
Centro Operativo AIDS
Viale Regina Elena, 299
I T-00161 Rome
Italy
Tel: +39 06 49387209
Fax: +39 06 49387210
E-mail: gianni.rezza@iss.it
Website: http://www.iss.it/
10Ray BrettleRegional Infectious Diseases Unit
Western General NHS Trust
Crewe Road South
UK-EH4 2XU Edinburgh
United Kingdom
Tel: +44 131 537 2841
Fax: +44 131 537 2878
E-mail: ray.brettle@ed.ac.uk
11Osamah HamoudaRobert 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/
12Francois DabisINSERM U.330 - ISPED (Case 11)
Université Victor Segalen Bordeaux 2
FR-33076 BORDEAUX Cedex
France
Tel: +33 5 57 57 14 36
Fax: +33 5 57 57 45 28
E-mail: Francois.dabis@isped.u-bordeaux2.fr
Website: http://www.isped.u-bordeaux2.fr
13Christine A LeeRoyal Free and University College School of Medicine
Department of Haematology
Pond Street
UK-NW3 2QG London
United Kingdom
Tel: +44 20 7830 2238
Fax: +44 20 7830 2178
E-mail: lee@rfhsm.ac.uk
14Julia Del AmoSecretaria Plan Nacional del Sida
Bravo Murillo 4
ES-28015 Madrid
Spain
Tel: +34 91 447 4262
Fax: +34 91 447 4563
E-mail: jamo@msc.es
15Noel GillPHLS CDSC
61 Colindale Avenue
UK-NW9 5EQ London
United Kingdom
Tel: +44 20 8200 6868/4462
Fax: +44 20 8200 7868
E-mail: ngill@phls.co.uk
Website: http://www.phls.org.uk

 
 
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