Clinical trials

HIV Kohortenstudie

HIV Kohortenstudie

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Acute HIV Infection: Zurich Primary HIV Infection Study

Acute HIV Infection: Zurich Primary HIV Infection Study




Despite a considerable body of knowledge that has been accumulated over the past decades and major successes in the treatment of HIV infection, neither an effective vaccine nor an eradication of HIV by drug intervention are within reach. Current antiretroviral treatment (ART) has dramatically reduced morbidity and development of AIDS in industrialized countries. To date however success of ART necessitates a life-long, continuous therapy as drug control the virus but cannot eliminate it form the latent reservoir. In order to control HIV-1 infection in the future, three main pillars are necessary: i) Optimal treatment of patients to control disease and limit transmission, ii) Resolving the underlying biology that leads to HIV latency to allow development of novel therapies leading to eradication of HIV from the infected individual (cure). iii) Defining protective immune responses against HIV to allow the development of effective vaccines. A key focus of research to reach these goals is the acute HIV infection as during this stage the latent reservoir is formed and the immune system is primed.

 

The research of acute HIV Infection is the key focus of the Zurich Primary HIV Infection Study (ZPHI). The ZPHI is an open label, non-randomized, observational, monocenter study at the University Hospital Zurich, Division of Infectious Diseases and Hospital Epidemiology and has been started at the beginning of 2002. The ZPHI is conducted by Prof. Huldrych Günthard. Since 2002, the ZPHI has enrolled more than 360 patients with a documented primary HIV infection (PHI). Recruitment of patients with a PHI into the ZPHI is ongoing. The ZPHI aims to describe the epidemiology of PHI, to longitudinally follow patients with a PHI, to test the effect of early antiretroviral treatment (ART) and to investigate clinical presentation and early events of virus-host interactions in patients with a documented PHI in Zurich.

 

The ZPHI belongs to the largest PHI studies in the western world, including well-described patients defined by using very strict PHI criteria. The ZPHI has published more than 50 original articles and reviews within the last ten years. The research platform of the ZPHI-study includes internationally renowned research groups within the areas of clinical infectious diseases, basic virology, immunology, genetics, evolution and bioinformatics research. Through this platform we have the possibility to perform innovative, pathogenesis-oriented clinical trials and basic research centering around HIV transmission, formation of the viral reservoir and its eradication. The platform further provides interesting training opportunities for master students (Medicine and Faculty of Science), PhD, MD-PhD students, postdocs and clinical researchers in different disciplines (microbiology, immunology, epidemiology / Biostatistics, Bioinformatics / Biomathematics, infectious diseases).

 

Areas of interest within the Zurich Primary HIV Infection Study

Clinical/epidemiological research:

  • Optimal treatment of acute HIV-1 infection.
  • Performance of clinical trials for studying various eradication-strategies in regard to reducing the latent reservoir.
  • Study of the early clinical presentation during acute HIV infection.
  • Study of the transmission of other sexually transmitted diseases (e.g., syphilis, chlamydia, gonorrhea, hepatitis C virus infection).
  • Identification of transmission networks within and outside the ZPHI by molecular-epidemiological methods to start targeted prevention.
  • Study of the transmission and development of drug resistance.
  • Clarify the question regarding transmission of drug resistant minority variants during the acute HIV infection or de novo evolution of drug resistant minority variants.

 

Translational:

  • Identification of biological characteristics of the transmitted viruses.
  • Identification of "Transmission Pairs" and studies of HIV in the "transmitter" and "Recipient".
  • Characterization of residual transcription/virus production under antiretroviral therapy.
  • Study of Virus - host interactions.
  • Identification of human genetic patterns that may be associated with acute retroviral syndrome.
  • Molecular characterization of newly transmitted viruses in ZPHI patients infected with hepatitis C virus using NGS technology.

 

Basic science:

  • B-cell function and maturation of the humoral immune response during the acute and in the chronic phase of HIV infection.
  • Co-stimulation and immune activation of non HIV-1-infected CD4 and CD8 cells during the HIV-specific cellular immune response.
  • Studies of mechanisms of immune-activation under anti-retroviral therapy.
  • Inter-versus intra-host evolution of HIV.
  • Studies of viral latency.
  • Identification of small non-coding RNAs HIV and possible role in the regulation of the same on HIV-1 or HIV replication latency.

 

ZPHI Study - the heart of many research projects

 

 

Publikationen

http://www.viralinfectiousdiseases.uzh.ch/Publications.html

Auskunft und Sekretariat

Tel.+41 44 255 33 22
Fax +41 44 255 44 99

Team

  • Prof Dr. med. Huldrych Günthard, senior staff physician division of infectious diseases and hospital epidemiology, head of the HIV research laboratory, president of the shcs
  • Prof. Karin Metzner, head of laboratory group
  • Prof. Roger Kouyos, head of laboratory group
  • Dr. med. Dominique Braun, research attending physician
  • Christina Grube, study nurse
  • Dr. med. Michael Greiner, fellow for infectious diseases and hospital epidemiology
  • Dr. med. Daniela Bircher, fellow for  infectious diseases and hospital epidemiology
  • Herbert Kuster, head of laboratory
  • Dominique Klimpel, laboratory assistant
  • Christine Leemann, laboratory assistant
  • Stefan Schmutz, laboratory assistant
  • Chantal von Siebenthal, laboratory assistant
  • Corinne Schenkel, laboratory assistant
  • Dr. Valentina Vongrad, Postdoc
  • Dr. Alexandra Scherrer, Postdoc
  • Nottania Campbell, PhD student
  • Corinna Oberle, PhD student
  • Victoria Strouvelle, PhD student
  • Yik Lim Kok, PhD student
  • Alex Marzel, PhD student
  • Mohaned Shilaih, PhD student
Transplantationskohortenstudie STCS

Transplantationskohortenstudie STCS

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Vascular graft infections

Vascular graft infections

Vascular grafts are increasingly implanted due to an increasing prevalence of atherosclerosis and diabetes, and about 1-6% of vascular procedures are complicated by infection. Mortality attributable to prosthetic vascular graft infections (PVGI) is high. However, there are almost no data regarding best treatment options of such complicated infections. Most recommendations are based on expert opinion and not on clinical trials or cohort observational data analyses. Evaluating infectious and other complications after vascular surgery procedures are important, and additionally, such studies may offer insights for quality improvement and improved patient outcomes.

We created a prospective observational cohort database on patients with an incident prosthetic vascular graft infection (VASGRA). Additionally, we established a biobank with the collection of tissue- and blood samples of patients

See more…. (LINK auf „Group Hasse“)

Orthopedic infections

Orthopedic infections

We work as infectious diseases consultants at the University Hospital Balgrist in Zurich. In a great collaboration with colleagues of internal medicine (Dr. med. J. Burkard and team), orthopedic surgeons (Prof. Dr. med. C. Gerber and his team), and microbiologists, we give advices for optimal antimicrobial treatment in patients with prosthetic joint infections and osteomyelitis. Through clinical collaboration, many scientific questions many questions arise, which we retrospectively and prospectively investigate. We make studies on epidemiology, pathogenesis, diagnostics, treatment and course of orthopedic infections.

In particular, we pursue the following specific aims:

  • Monitoring and improving the existing diagnosis of orthopedic infections. Evaluation of new diagnostic methods.
  • Retrospective and prospective analysis of applied treatments (antibiotics, surgical procedures) with focus on long-term course of the infection and detection of antibiotic side effects.



    Projects

    • Quality control study to optimize diagnosis of periprosthetic joint infections (PJI). KEK-ZH-Nr. 2015-0357.
    • Dr. med Yvonne Achermann, Oberärztin, Infektionskrankheiten und Spitalhygiene, USZ
    • Prof. Dr. med. Annelies Zinkernagel, Leitende Ärztin , Infektionskrankheiten und Spitalhygiene, USZ
    • Prof. Dr. med. Rainer Weber, Chefarzt, , Infektionskrankheiten und Spitalhygiene, USZ
    • Prof. Dr. med. Christian Gerber, Chefarzt, Orthopädie, Balgrist und Team
    • Prof. Dr. med. Reinhard Zbinden, Institut für medizinische Mikrobiologie, Universität Zürich
    • Prof. Dr. Georgios Belibasakis, Zentrum für Zahnmedizin, Universität Zürich
    • Study Nurse

    Kontaktadresse

    Dr. med Yvonne Achermann
    Klinik für Infektionskrankheiten und Spitalhygiene
    UniversitätsSpital Zürich
    Rämistrasse 100
    8091 Zürich
    Tel +41 44 255 21 73
    yvonne.achermann@usz.ch

Klinische Phase III Studien

Klinische Phase III Studien

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