Research focus: HIV, hepatitis C, sexually transmitted infections, HIV pre-exposure prophylaxis and COVID-19 infection.
The term sexually transmitted infection (STI) describes a large number of clinical syndromes and infections that can be acquired and transmitted through sexual contact by various pathogens. In industrialized nations, including Switzerland, the “classic” STIs such as syphilis, chlamydia and gonorrhea are on the rise and there are cases of multi-resistant STIs that are difficult to treat.
The number of newly diagnosed HIV cases in Switzerland has declined slightly over the past few years, which is primarily due to the wider availability of HIV pre-exposure prophylaxis, increased testing and the immediate start of antiretroviral therapy in newly diagnosed individuals. However, there are still a number of unresolved problems such as a lack of cure, side effects of HIV medication, and the aging of people living with HIV.
For hepatitis C, it is estimated that around 40,000 infected people live in Switzerland, the majority of whom are undiagnosed and therefore exposed to a risk of complications.
COVID-19 dominates our everyday life in and outside the hospital and although progress has been made in treatment over the past few months, there is need for new therapeutic approaches. In this context, carefully carried out clinical studies are essential in order to be able to achieve medical progress in the treatment of COVID disease.
Improved prevention, diagnosis and therapy of the above-mentioned infectious diseases as well as the implementation of clinical studies to gain knowledge and progress are the main goals of this research group.
The Swiss HIV Cohort Study (SHCS) is a clinic based, multicenter longitudinal study enrolling HIV-infected women and men of all transmission routes. The study is active in research in clinical HIV medicine and in the field of basic, social and preventive sciences. It was started in 1988 and enrolls > 19’000 patients. The SHCS is instrumental for the high quality of care that HIV-medicine has achieved in Switzerland and in general for a better understanding of the virus – host interactions between HIV and the human body. (www.shcs.ch). To date, several research projects are ongoing in the SHCS, including antiretroviral therapy simplification trials, assessment of HIV-related stigma, investigating the interplay between HIV and tuberculosis.
The ZPHI is an ongoing, investigator initiated, multi-center trial conducted at the University Hospital Zurich (USZ). The ZPHI is the main basis for various national and international research projects. ZPHI Study cohort focuses on a unique patient population that is difficult to identify and recruit, namely patients with acute or recent HIV-1 infection. Acutely infected and early ART treated individuals represent one of the key target populations for proving HIV-1 eradication strategies as they have due to the early onset of ART a low latent reservoir which is the optimal setting for eradication interventions to be successful. The ZPHI recruits these individuals upon diagnosis of HIV-1 infection and has to date enrolled more than 450 individuals with a documented acute or recent HIV-1 infection. The ZPHI participants are followed longitudinally at trimonthly clinical visits. Clinical and demographic data alongside a wide spectrum of investigative measurements are collected.
The SwissPrEPared study is a nation-wide program for surveillance and for exchanging experiences related to HIV pre-exposure prophylaxis (PrEP) consultations. The goal is to ensure best care for individuals seeking for PrEP. Data generated by the study will be used to explore specific research questions in the context of PrEP. Ultimately, the ‘SwissPrEPared’ program prepares the ground for a broader strategy directed at stopping the HIV epidemic in Switzerland, thereby meeting the “90-90-90” UNAIDS target*. The ultimate goal is HIV elimination in Switzerland i.e. no new infections.
Department of Infectious Diseases and Hospital Epidemiology
PD Dr. med. Dominique Braun
University Hospital Zurich