Sudre P, Rickenbach M, Taffé P, Janin P, Volkart A C, Francioli P
Division autonome de médecine préventive hospitalière, CHUV, Lausanne.
Schweiz Med Wochenschr. 2000 Oct 14;130(41):1493-500.
The Swiss HIV Cohort Study (SHCS) was initiated in 1988 and represented the main scientific component of the comprehensive response to the AIDS epidemic in Switzerland. It brought together physicians and scientists from five university hospitals (Basel, Berne, Geneva, Lausanne and Zurich) and two Cantonal hospitals (Lugano and St. Gallen). The objective of SHCS was, and still is, to produce rapid, high quality patient-oriented medical research in the field of HIV infection.
SHCS is a prospective population-based cohort study. Any HIV-infected person aged > or = 16 years is eligible to participate. Data collection and study procedures are standardised. Data quality and protocol monitoring are conducted at the coordination and data centre in Lausanne. Detailed information on demographics, income, mode of HIV acquisition, risk behaviours, clinical events, laboratory results, treatment and treatment tolerance is collected at registration and at 6-monthly intervals.
Since 1996, 10,600 persons have been enrolled and the SHCS study population is considered fairly representative of the HIV-infected population in Switzerland, at least in terms of gender and mode of HIV acquisition. In 1999, 4600 patients were actively followed up and more than 70% of patients were receiving highly active antiretroviral therapy (HAART). As a consequence, mortality and the incidence of HIV-related opportunistic infections have decreased significantly in the recent past. Between 1996 and 2000, 91 original manuscripts have been published by SHCS scientists and physicians, almost exclusively in peer-reviewed journals. A wide range of scientific questions have been addressed, including HIV primary infection, the natural history of HIV infection, the clinical and biological impact of HAART, drug resistance, risk factors for disease evolution including the timing of treatment initiation, the role of CD4 receptors, the validity of HIV surveillance reports, determinants of treatment access and tolerance, clinical trials of new drug combinations, the interruption of prophylaxis following a favourable response to HAART and issues relating to quality of life and interaction between income, social level and disease evolution.
The SHCS has had, and continues to have, a significant impact on medical practice, public health and research in Switzerland and beyond. It represents a network of excellence which has brought together and fostered intensive collaboration between physicians and institutions throughout this country and beyond. This was possible thanks to the support of the Federal Office of Public Health and the commitment of primary care physicians, researchers and patients. This project may be model for focused and prioritised multicentre and transdisciplinary research programmes.
瑞士艾滋病毒队列研究（SHCS）始于1988年，是瑞士应对艾滋病疫情综合举措的主要科学组成部分。它汇聚了来自五所大学医院（巴塞尔、伯尔尼、日内瓦、洛桑和苏黎世）以及两所州立医院（卢加诺和圣加伦）的医生和科学家。SHCS的目标过去是、现在仍然是在艾滋病毒感染领域开展快速、高质量的以患者为导向的医学研究。
SHCS是一项基于人群的前瞻性队列研究。任何年龄大于或等于16岁的艾滋病毒感染者都有资格参与。数据收集和研究程序是标准化的。数据质量和方案监测在洛桑的协调与数据中心进行。在登记时以及每隔6个月收集关于人口统计学、收入、艾滋病毒感染途径、风险行为、临床事件、实验室结果、治疗及治疗耐受性的详细信息。
自1996年以来，已有10600人登记入组，SHCS研究人群被认为至少在性别和艾滋病毒感染途径方面能较好地代表瑞士的艾滋病毒感染人群。1999年，4600名患者得到积极随访，超过70%的患者正在接受高效抗逆转录病毒治疗（HAART）。因此，近期死亡率和与艾滋病毒相关的机会性感染发生率显著下降。1996年至2000年间，SHCS的科学家和医生共发表了91篇原创手稿，几乎全部发表在同行评审期刊上。研究涉及广泛的科学问题，包括艾滋病毒原发感染、艾滋病毒感染的自然史、HAART的临床和生物学影响、耐药性、疾病演变的风险因素（包括开始治疗的时机）、CD4受体的作用、艾滋病毒监测报告的有效性、治疗可及性和耐受性的决定因素、新药组合的临床试验、HAART取得良好疗效后预防措施的中断以及与生活质量以及收入、社会阶层和疾病演变之间相互作用相关的问题。
SHCS过去和现在都对瑞士及其他地区的医疗实践、公共卫生和研究产生了重大影响。它代表了一个卓越的网络，汇集并促进了瑞士国内外医生和机构之间的密切合作。这得益于联邦公共卫生办公室的支持以及基层医疗医生、研究人员和患者的投入。该项目可能成为重点突出、有优先次序的多中心和跨学科研究项目的典范。
