Despite more than 25 years of HIV research, urgent questions remain to be answered in order to improve prevention and management of the HIV epidemic.
These questions concern all phases of the natural and treatment course of HIV disease and include:
(i) How to prevent ongoing HIV transmission (e.g. early treatment versus intensified preventionefforts)?;
(ii) How to treat HIV, respectively optimize treatment with regard to long-term efficacy, adherence, toxicity, prevention of resistance?;
(iii) Is it possible to cure HIV by diagnosing and treating very early after transmission?;
(iv) What are the key host and viral genetic factors that determine the natural course of HIV infection?;
(v) Which are thelong-term effects of HIV-infection on cardiovascular morbidity, renal and liver disease, metabolic complications, bone disease and cancer?;
(vi) What is the long-term impact of HIV infection on quality of life and ability to work?;
(vii) To which extent does HIV impair neurocognitive performance and how can this be
(viii) What are the optimal interventions to control emerging coinfection epidemics such as hepatitis C and syphilis?;
(ix) Which are the long-term consequences of HIV and antiretroviral therapy on pregnancy,
childhood and adolescence?
(x) What is the impact of HIV-infection on psychosocial issues and health-care usage?;
(xi) What are the key differences and similarities between HIV disease in developed compared to resource limited settings?
Numerous specific ongoing and planned research projects will investigate these research questions in detail by taking advantage of the comprehensive SHCS framework. Importantly, the unbiased extensive routine collection of clinical and laboratorydata allows to detect and address emerging diseases and research priorities without relying on a-priori hypotheses.
This allows to capture large numbers of common events in a representative way, as well as to identify rare extremes of HIV disease (e.g. elite controllers or rapid progressors) which can provide key insights into HIV pathogenesis.
The main objective is to continue to perform and facilitate a wide range of timely research projects of high quality through a national network of research integrated in the management of the patients, and through interdisciplinary collaboration with all interested partners, including public health authorities, patient's association, industry and international initiatives.
The objectives of the SHCS project can be divided into core research projects and nested research projects.