Objectives
The overarching aim of the SHCS is to improve health of persons living with HIV through clinical, translational and basic science studies, and to strengthen collaborative and transdisciplinary research.
Despite more than 35 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 prevention efforts)?
(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 the long-term effects of HIV on cardiovascular morbidity, renal and liver disease, metabolic complications, bone disease and cancer?
(vi) What is the long-term impact of HIV on quality of life and ability to work?
(vii) To which extent does HIV impair neurocognitive performance and how can this be
prevented?
(viii) What are the optimal interventions to control emerging coinfection epidemics such as hepatitis B, 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 on psychosocial issues and health-care usage?
(xi) What are the key differences and similarities between HIV disease in high-income versus low-income 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 laboratory data allows to detect and address emerging diseases and research priorities without relying on a-priori hypotheses.
The SHCS infrastructure allows to capture large numbers of common events in a representative way, as well as to identify rare extremes of HIV disease, which can provide key insights into HIV pathogenesis.