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Günthard

Fakultäten » Medizinische Fakultät » Infektionskrankheiten und Spitalhygiene, Klinik für » Prof. Dr. Huldrych Günthard » Günthard

Completed research project

Title / Titel ZIEL Study: "Zurich HIV Genotyping and Drug Level - Study."
PDF Abstract (PDF, 14 KB)
Summary / Zusammenfassung HIV-drug resistance testing is very expensive and long-term clinical benefit has not been proven yet. Nevertheless, groups of experts have recommended to use resistance testing routinely. This study was initiated to implement clinical drug resistance testing in conjunction with drug level monitoring in a controlled manner into the management of HIV-infected patients.

The aims of this study are
- to optimize clinical management of HIV-infected patients by introducing drug resistance testing (genotyping) in combination with drug level monitoring (mainly protease inhibitors and non-nucleotide inhibitors) into clinical practise.
- to evaluate the decision support software RetrogramTM by comparing physicians choice of a regimen selected without genotype information and with genotype information to the decision made by the software package.
- to determine baseline mutations and combinations of such regarding prediction and failure of salvage regimens.

Over the period of 1-2 years we will enrole all Zürich participants in the Swiss HIV-Cohort Study (SHCS) who belong to one of the following groups: 1) patients failing an antiretroviral drug regimen, 2) HIV-infected, antiretroviral drug-naive patients before starting combination antiretroviral treatment. 3) All HIV-infected patients with an acute HIV-infection. A total of 200 patients should be enrolled, of which 130 have been included within the first year of the study and are prospectively followed in the SHCS. Virological, immunological and clinical response to resistance-test guided therapy-switches will be assessed by comparing matched control groups from the SHCS with patients enrolled into ZIEL. The impact of resistance testing on the physicians choice to pick a drug regimen in comparison to the choice based only on drug history will be assessed in a standardized way.
Publications / Publikationen Günthard HF, Wong JK, Ignacio C, Havlir DV, Richman DD. Comparative Performance of High Density Oligonucleotide Sequencing and Dideoxynucleotide Sequencing of HIV-1 Pol from Clinical Samples. AIDS Research and Human Retroviruses. 1998;14:867-874.

Leigh Brown AL, Günthard HF, Wong JK, D'Aquila RT, Johnson VA, Kuritzkes DR, Richman DD. Sequence Clusters in Human Immundodeficiency Virus Type 1 Reverse Transcriptase are Associated with Subsequent Virological Response. Journal of Infectious Diseases. 1999; 180(4):1043-1049.

Günthard HF, Leigh Brown A, D'Aquila RT, Johnson V, Kuritzkes D, Richman D, Wong JK. Higher Selection Pressure from Antiretroviral Drugs in Vivo Results in Increased Evolutionary Distance in HIV-1 pol. Virology. 1999; 259:154-165.

Keywords / Suchbegriffe HIV, antiretroviral therapy, drug resistance testing, genotypic drug resistance, HIV-drug resistance, drug level monitoring, decision support software
Project leadership and contacts /
Projektleitung und Kontakte
PD Dr. med. H. Günthard (Project Leader) huldrych.guenthard@dim.usz.ch
Prof. Dr. med. R. Weber rainer.weber@dim.usz.ch
PD Dr. med. B. Ledergerber bruno.ledergerber@dim.usz.ch
Dr. J. Böni jboeni@immv.uzh.ch
Funding source(s) /
Unterstützt durch
SNF (Personen- und Projektförderung), Private Sector (e.g. Industry)
Roche Pharma Schweiz AG, Reinach, SNF (Swiss HIV Cohort Study)
In collaboration with /
In Zusammenarbeit mit
Dr. J. Böni / Prof. Dr. med. J. Schüpbach / Nationales Zentrum für Retroviren, Universität Zürich, 8028 Zürich Switzerland
Dr. Ch. Hirt, Roche Pharma Schweiz AG, Reinach
Duration of Project / Projektdauer May 2000 to Dec 2002