The research themes are all coordinated by separate working groups, each with collaborators from different participating centres
Ongoing monitoring of outcomes (including the development of resistance) among those infected with HIV
The large number of patients in the database and the collection of longitudinal data makes the study of various outcomes of HIV infection possible. These include the monitoring of AIDS diagnoses, deaths and serious non-AIDS events like cardiovascular disease, certain cancers, liver and kidney disease. The use of first drug combinations and switching to second and third drug combinations can be studied, as well as the virological and immunological responses to these. As the HIV virus can become resistant to the effect of the drugs used, monitoring of viral resistance is important. Use of the database together with related resistance test data in the UK HIV Drug Resistance database will allow study of the development of resistance, and the impact of resistance testing on patient outcomes in a routine clinical setting.
Group: UK CHIC Steering Committee.
Pregnancy: The impact of antiretroviral therapy received during pregnancy on the health of HIV-infected women
The number of HIV-infected women in the UK is increasing, as are the number of pregnancies in HIV-infected women. This is largely due to increased survival rates in those women receiving treatment, and earlier HIV diagnosis following the introduction of antenatal HIV screening in the UK. Treatment with antiretroviral therapy during pregnancy, either to prevent transmission to the baby or for the mother's own health, has meant that mother-to-child transmission is now a rare event. Hoverver, the long-term implications for the women of such treatment are unknown. UK CHIC study data will be used to understand more about the effect on the health of HIV-infected women of HIV drug treatment received during pregnancy.
Group: Claire Thorne, Pat Tookey, Jane Anderson, Graham Taylor, Marie-Louise Newell, Caroline Sabin, Deenan Pillay, Susie Huntington.
Hepatitis co-infection: The impact of co-infection with HCV and/or HBV
Around 7% of HIV positive individuals in the UK are also infected with hepatitis B or C. Individuals who are infected with both HIV and hepatitis B/C are likely to experience more rapid progression of liver disease, but the impact of co-infection on progression of HIV disease is unclear. Data from the UK CHIC study will be used to investigate the effect of infection with both hepatitis and HIV on health and the progression of HIV disease.
Group: Mark Nelson, Sanjay Bhagani, Richard Gilson, Alison Rodger, Janice Main, Andy Burroughs, Caroline Sabin, Chris Taylor.
HIV and Ageing: The implications of an ageing HIV population
Due to improvements in the treatment of HIV, the number of patients older than 50 years has increased. Since both HIV and ageing are associated with changes in immunity and host defence, it is possible that HIV may accelerate several age-related conditions. It is therefore more important to study a number of age-related conditions in HIV-infected individuals such as cardiovascular disease, renal and liver disease, cognitive defects and bone mineral loss. HIV-infected individuals already receiving drug treatment for HIV may also experience different drug-drug interactions of treatment for age-related health problems, or they may have different levels of drug absorption and metabolism than younger people.
Group: Alan Winston, Frank Post, Marta Boffito, Caroline Sabin, Ian Williams, Jane Anderson, Paddy Mallon, Karen Walker-Bone, Jonathan Elford, Arne Akbar, Alec Miners.
Understanding the transmission and persistance of drug resistant HIV
The clinical and viral resistance data that are collected will allow studies of infectivity at the population level, and of the factors that may be responsible for driving the transmission of drug resistant HIV. Of interest is whether viral resistance is likely to persist in patients who have been infected with resistant virus and, if so, if this has any implications for their response when they start treatment.
Group: UK HIV Drug Resistance Database Steering Committee.