1. EuroCoord – European network of HIV/AIDS cohort studies for a global co-ordination on clinical research Caroline Sabin EuroCoord Scientific Co-ordinator UCL, London

2. Background EU-funded NoE established by several of the biggest HIV cohorts and collaborations within Europe Funded for 5 years from January 2011 Aims to exploit the scientific strength of each participating network, and build on complementarities between them, to enhance the research conducted across Europe, thus providing ‘added value’

3. Founding networks 23 beneficiaries from 16 countries (> 100 collaborating centres/third parties), ensuring representativeness across Europe.

4. Key research aims 1.To improve the management and life of HIV-positive individuals, by: Characterising and modelling HIV-positive populations in Europe; Improving understanding of pathogenesis; Documenting uptake of and response to therapy; Evaluating implications of long-term HIV infection and ART exposure; Assessing implications of specific management strategies; Analysing effects and improving management of hepatitis and tuberculosis (TB) co-infection.

5. Key research aims 1.To improve the management and life of HIV-positive individuals, by: Characterising and modelling HIV-positive populations in Europe; Improving understanding of pathogenesis; Documenting uptake of and response to therapy; Evaluating implications of long-term HIV infection and ART exposure; Assessing implications of specific management strategies; Analysing effects and improving management of hepatitis and tuberculosis (TB) co-infection. 2.To develop and implement novel methodology, research platforms and technologies. 3.To establish training programmes to improve clinical management and research skills

6. Workpackage structure

7. WP2: Training and outreach  Build on existing training activities (e.g. ACTIVATE, NEAT, CHAIN and within networks) to augment and update skills of health professionals and researchers  Provide clinical management skills and statistical/epidemiological training

8. Workpackage structure WP3: Scientific oversight  Co-ordinate scientific work to ensure maximal synergy  Facilitate translation of research into policy  Facilitate collaboration with other EU- funded research networks (e.g. CHAIN)

9. Specialist subgroups Pharmacokinetics and pharmacology Immunology/HIV virology Statistical methodology Improving the management of hepatitis Co-infection

10. Workpackage structure WP4: Data management  Harmonize collection of data items between cohorts/networks;  Encourage discussion of data formats, SOPs, protocols and quality assurance checks

11. Characterising HIV populations Timing of diagnosis/presentation in pregnancy Vertical transmission despite PMTCT Focus on Eastern European cohorts Production of assay for incidence testing Test new diagnoses in C&E Europe and estimate incidence Contribution of primary infection to propagation of epidemic Regional differences in populations Adherence to guidelines and ART outcomes Standardise definitions of late presentation Epidemiology and temporal trends

12. Understanding pathogenesis Drug classes & CD4 cell subset dynamics CD4 cell subset changes in response to ART/virological failure Host genetic factors Predictors of tropism use and change Long-term non-progression and elite control HIV resistance and viral tropism Ultrasensitive genotypic tests Activated inflammation, coagulation and soluble plasma cancer markers European registry of HIV controllers HIV-1 vs. HIV-2 progression

13. Treatment uptake and outcomes Pharmacokinetics Treatment in infants Treatment interruption and outcomes of restarting ART Pharmacovigilance; ART in pregnancy Population effectiveness of ART management Effect of HIV infection duration Temporal/regional differences in timing of ART Type of ART and outcomes Frequency and outcomes of switching Database of HIV drug resistance mutations Robust clinical tool for expected CD4 response following cART Implications of short-term antenatal ART

14. New collaborative themes HIV and TB (WP 13) - Monitor incidence, long-term prognosis and temporal changes - Effects of anti-TB therapy and prophylaxis - Impact on management of HIV - Risk factors for IRIS HIV and Migrants (WP 14) - Determination of likely country of acquisition - Identify barriers to prevention, testing and treatment - Key HIV outcomes and relationship with country of habitation. Modelling (WP 15) - Develop existing computer simulation model to provide Europe- wide consensus estimates for rates of diagnosis, treatment usage, resistance, pregnancy, AIDS/death etc.

15. Summary HIV EuroCoord will strengthen European HIV cohort research, by bringing it within a single pan-European network of cohort studies A multidisciplinary approach, and access to data from >250,000 HIV-positive individuals, will allow us to address key areas of research aimed at improving the management and life of HIV-positive individuals By utilising a common research platform, we will ensure that the most complementary, collaborative and competitive science is untaken

16. Acknowledgements Executive Board: Geneviève Chêne, University of Bordeaux II, France; Dominique Costagliola, Institut National de la Santé et de la Recherche Médicale, France Julia Del Amo, Instituto de Salud Carlos III, Spain; Carlo Giaquinto, Fondazione PENTA, Italy; Di Gibb, Medical Research Council, UK; Jesper Grarup, Københavns Universitet, Denmark; Ole Kirk, Københavns Universitet, Denmark; Bruno Ledergerber, University of Zurich, Switzerland; Laurence Meyer, Institut National de la Santé et de la Recherche Médicale, France; Alex Panteleev, St. Petersburg City AIDS Centre, Russian Federation; Andrew Phillips, University College London, UK, Kholoud Porter (Chair), Medical Research Council, UK; Caroline Sabin (Scientific Coordinator), University College London, UK, Claire Thorne, University College London, UK; Stephen Welch, Fondazione PENTA, UK. Council of Partners: Jean-Pierre Aboulker, Institut National de la Santé et de la Recherche Médicale, France; Jan Albert, Karolinska Institute, Sweden; Silvia Asandi, Romanian Angel Appeal Foundation, Romania; Geneviève Chêne, University of Bordeaux II, France; Dominique Costagliola, INSERM, France; Antonella d’Arminio Monforte, ICoNA Foundation, Italy; Stéphane De Wit, St. Pierre University Hospital, Belgium; Frank De Wolf (Chair), Stichting HIV Monitoring, Netherlands; Julia Del Amo, Instituto de Salud Carlos III, Spain; José Gatell, Fundació Privada Clínic per a la Recerca Bíomèdica, Spain; Carlo Giaquinto, Fondazione PENTA, Italy; Osamah Hamouda, Robert Koch Institut, Germany; Igor Karpov, University of Minsk, Belarus; Bruno Ledergerber, University of Zurich, Switzerland; Jens Lundgren, Københavns Universitet, Denmark; Ruslan Malyuta, Perinatal Prevention of AIDS Initiative, Ukraine; Claus Møller, Cadpeople A/S, Denmark; Andrew Phillips, University College London, UK; Kholoud Porter, Medical Research Council, United Kingdom; Maria Prins, Academic Medical Centre, Netherlands; Aza Rakhmanova, St. Petersburg City AIDS Centre, Russian Federation; Jürgen Rockstroh, University of Bonn, Germany; Magda Rosinska, National Institute of Public Health, National Institute of Hygiene, Poland; Claire Thorne, University College London, UK; Giota Touloumi, National and Kapodistrian University of Athens, Greece; Alain Volny Anne, European AIDS Treatment Group, France. External Advisory Board: David Cooper, University of New South Wales, Australia; Nikos Dedes, Positive Voice, Greece; Kevin Fenton, Centers for Disease Control and Prevention, USA; David Pizzuti, Gilead Sciences, USA; Marco Vitoria, World Health Organisation, Switzerland.. Secretariat: Kate Coughlin, MRC Clinical Trials Unit, UK; Michelle Ellefson, Københavns Universitet, Denmark; Silvia Faggion, Fondazione PENTA, Italy; Richard Frost, MRC Regional Centre London, UK; Marie Reynolds, MRC Clinical Trials Unit, UK; Christine Schwimmer, University of Bordeaux II, France; Martin Scott, UCL European Research & Development Office, UK.

17. www.etudes.isped.u-bordeaux2.fr/cohere/ www.cphiv.dk/EuroSIDA/tabid/59.aspx www.cascade-collaboration.org www.pentatrials.org www.EuroCoord.net or Contact info@EuroCoord.net