The world's largest multinational cohort study of HIV-infected patients has received a funding boost from the European Commission (EC) in Brussels. A new four-year grant of 1.2 million EUROS ($1.8 million) from the commission will help EuroSIDA—a study originated in 1979 and headed by Jens D. Lundgren of Hvidovre University Hospital in Denmark—to continue assessing how anti-HIV therapies affect the course of chronic infection based on 8,500 patients in 20 countries.

Particular focus will be placed on the treatment of HIV in Eastern Europe, where AIDS is increasing through intravenous drug use. Although a number of Eastern European countries are already involved in the project, Lundgren says that additional countries, such as the Baltic States and hopefully the Ukraine, will be added over the next four years. Eventually the number of patients covered by the study is expected to increase to 12,000.

“This new money is valuable because it will allow us to initiate an extensive analysis of the plasma bank that we have built up from volunteers participating in the study,” says Lundgren. He adds, “Such an analysis will provide us with important information about the role of resistance to antiretroviral therapies.” In addition to funding from the EC's Biomed programs, EuroSIDA receives a similar level of support from the pharmaceutical companies GlaxoSmithKline, Roche and Boehringer Ingelheim.

Another goal is to assess the patterns of HIV-related diseases. The study has already shown that the pattern in patients receiving highly active antiretroviral therapy (HAART) is changing, with relatively more cases of non-Hodgkin lymphoma and an increase in the number of patients who are dying without having experienced a so-called 'AIDS-defining' disease. One possible explanation is the late-onset side effects from HAART, such as increased risk of cardiovascular disease. “The possible long-term side effects are something that the new money will allow us to study more closely,” says Lundgren.

EuroSIDA's data on the effectiveness of HAART have already had implications for treatment guidelines. For example, the information that HAART induced reconstitution of the immune system—as indicated by a rise in blood C4+ lymphocyte levels—enabled chemoprophylaxis of opportunistic infections to be safely discontinued and have contributed to the recent revision of treatment guidelines in the US (http://hivatis.org/trtgdlns.html).