Jan Fehr

  

Group members

Projects

HIV – global health aspects

Our research focuses on global health challenges. Through a strong partnership with the Infectious Diseases Institute (IDI) of Makerere University in Kampala, Uganda, we are able to investigate fundamental clinical research questions that affect patients around the globe.

We currently have two active research projects, which both take place at the IDI in Kampala: The first project investigates the association between anti-Tuberculosis (TB) drug concentrations and treatment outcome in TB/HIV co-infected Ugandans. The second research project concerns virological monitoring and drug resistance in HIV-infected adults presenting to the IDI in Kampala.

So far, we have concentrated our research on HIV and TB. In the future, we plan to add non-communicable diseases (NCDs), as well as "One Health" pathologies and neglected tropical diseases (NTDs) to our field of research.

"SOUTH": Study on Outcomes related to Tuberculosis and HIV drug concentrations in Uganda

This currently ongoing research study investigates the association between anti-TB drug concentrations and TB treatment outcome in TB/HIV co-infected Ugandan adults. Serum concentrations of all four standard anti-TB drugs, as well as selected antiretroviral drugs are measured at baseline, week 2, week 8, and week 24 of anti-TB treatment. Additionally, data on symptoms, sputum smear and culture, as well as radiological features is collected. Serum drug concentrations are measured on site by a Ugandan laboratory technician trained in Zurich using a validated UV-HPLC method. Furthermore, the SOUTH study serves as a research platform for a variety of nested studies.

"RHINOS": Resistance in HIV-infected individuals in North and South

In 2015, this study enrolled over 2700 HIV-infected Ugandan adults within 4 months. The majority of patients had been on antiretroviral treatment (ART) for more than 6 months and received viral load testing. In case of virological failure, HIV drug resistance testing was performed. ART-naïve patients underwent HIV drug resistance testing in order to investigate for transmitted resistance mutations. All patients completed a detailed questionnaire on HIV and ART history, social and educational background, as well as recreational drugs use and concomitant medication in order to assess risk factors for treatment failure. The data collected in Uganda will be compared to patients of the Swiss HIV Cohort Study (SHCS).

Collaborations

University Hospital Zurich / University of Zurich, Zurich, Switzerland:
Bruno Ledergerber (Head Statistician, Division of Infectious Diseases and Hospital Epidemiology)
Daniel Müller (Head of Drug Analysis and Toxicology, Institute of Clinical Chemistry)
Ursula Gutteck (Senior Biomedical Scientist, Drug Analysis and Toxicology, Institute of Clinical Chemistry)
Natascia Corti (senior attending physician, Department of Clinical Pharmacology and Toxicology)
Alexander Jetter (senior attending physician, Department of Clinical Pharmacology and Toxicology)

Infectious Diseases Institute, Makerere University, Kampala, Uganda:
Andrew Kambugu (Head of Research Department)
Barbara Castelnuovo (Head of Longitudinal Studies & Principle Investigator SOUTH)
Mohammed Lamorde (Head of prevention, Treatment and Care & Head of PK unit)

Publications

Abstracts presented at international conferences:

1. High efavirenz serum concentrations in TB/HIV co-infected Ugandan adults receiving rifampicin-based anti-TB therapy; A. von Braun, C. Sekaggya, A. Buzibye, F. Mubiru, A. Kambugu, B. Castelnuovo, J. Fehr, Mohammed Lamorde; European AIDS Clinical Society (EACS), 21-24 October, 2015, Barcelona, Spain

2. High proportion of virological failure and HIV drug resistance among TB/HIV co-infected Ugandan adults; A. von Braun, C. Sekaggya, F. Mubiru, A. Kambugu, J. Fehr, B. Castelnuovo; European AIDS Clinical Society (EACS), 21-24 October, 2015, Barcelona, Spain

3. Importance of continuous monitoring of HIV-infected patients screened for pulmonary tuberculosis - independently of screening results; A. von Braun, C. Sekaggya, L. Henning, R. Nakijoba, I. Ariko, J. Mayito, D. Nalwanga, S. Okware, B. Castelnuovo, J. Fehr, A. Kambugu; European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), 25-28 April 2015, Kopenhagen, DK

4. Association of anti-tuberculosis drug levels serum concentrations with drug-related adverse events in TB/HIV co-infected patients in Uganda C. Sekaggya, A. von Braun, Ledergerber B, Buzibye A, Scherrer A, Lamorde M, Nalwanga D, L. Henning, Muller D, Gutteck U, B. Castelnuovo, A. Kambugu, J. Fehr; European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), 25-28 April 2015, Kopenhagen, DK

5. Low isoniazid and rifampicin concentrations in TB/HIV co-infected patients in Uganda; Sekaggya C, Lamorde M, Scherrer A.U, Musaazi J, Corti N, Buzibye A, Muller D, Nakijoba R, Gutteck U, Nalwanga D, Henning L, von Braun A, Okware S, Castelnuovo B, Kambugu A, Fehr J; HIV Drug Therapy Glasgow, 2-6 November 2014, Glasgow, UK

Original articles

1. "If at first you don't succeed, try again": Looking beyond Initial Results of a Failed Tuberculosis Diagnosis; A. von Braun, C. Sekaggya, L. Henning, R. Nakijoba, A. Kambugu, J. Fehr, B. Castelnuovo; Public Health Action, Vol 5 No 3, 21 September 2015, http://dx.doi.org/10.5588/pha.15.0029

Contact

Division of Infectious Diseases and Hospital Epidemiology
Dr. Jan Fehr, MD
University hospital Zurich
Raemistrasse 100
8091 Zurich
Tel. + 41 44 255 34 02
Fax +41 44 255 32 91