Research group Dominique Braun

The term sexually transmitted infection (STI) describes a large number of clinical syndromes and infections that can be acquired and transmitted through sexual contact by various pathogens. In industrialized nations, including Switzerland, the “classic” STIs such as syphilis, chlamydia and gonorrhea are on the rise and there are cases of multi-resistant STIs that are difficult to treat.

The number of newly diagnosed HIV cases in Switzerland has declined slightly over the past few years, which is primarily due to the wider availability of HIV pre-exposure prophylaxis, increased testing and the immediate start of antiretroviral therapy in newly diagnosed individuals. However, there are still a number of unresolved problems such as a lack of cure, side effects of HIV medication, and the aging of people living with HIV.

For hepatitis C, it is estimated that around 40,000 infected people live in Switzerland, the majority of whom are undiagnosed and therefore exposed to a risk of complications.

COVID-19 dominates our everyday life in and outside the hospital and although progress has been made in treatment over the past few months, there is need for new therapeutic approaches. In this context, carefully carried out clinical studies are essential in order to be able to achieve medical progress in the treatment of COVID disease.

Improved prevention, diagnosis and therapy of the above-mentioned infectious diseases as well as the implementation of clinical studies to gain knowledge and progress are the main goals of this research group.

Projects

Ongoing research projects

• Pharmacokinetics of remdesivir and GS-441524 in patients with severe renal insufficiency with and without intermittent hemodialysis.
• Prospective assessment of sexually transmitted infectious diseases using multiplex PCR in patients with an acute HIV infection from the Zurich Primary HIV Infection Study.
• Clinical characteristics and antibiotic resistance patterns of patients with Neisseria gonorrhoea infection at the University Hospital Zurich.
• Systematic re-screening for hepatitis C RNA among men who have sex with men living with HIV in the Swiss HIV Cohort Study to assess the post-intervention prevalence and incidence of replicating HCV infections following the Swiss HCVree Trial.

Ongoing clinical studies

• A phase IIA randomized double-blind placebo-controlled single-centre study of the effect of BCG vaccination on the HIV latent reservoir.
• Therapeutics for Inpatients with COVID-19 (TICO)” study: A Multicenter, Adaptive, Randomized, Blinded Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for Hospitalized Patients with COVID-19.
• CPT-ZPH study: A Phase I, open-label, single-centre clinical study to evaluate safety and efficacy of passive immunization of high-risk Sars-CoV-2 positive patients with convalescent plasma therapy
• CanCoVDia study: Canakinumab in patients with COVID-19 and Type 2 Diabetes, a multi-centric, randomized, double blind, placebo-controlled trial.
• A multicenter, phase III randomized, double-blind, placebo-controlled outpatient study to evaluate the efficacy, safety, antiviral activity, and pharmacokinetics of RO7496998 (AT-527) compared with placebo in non-hospitalized adults and adolescents with mild to moderate coronavirus disease 2019 (COVID-19).
• SOLAR study: A Study to Evaluate Efficacy and Safety of Cabotegravir (CAB) Long Acting (LA) Plus (+) Rilpivirine (RPV) LA Versus BIKTARVY® (BIK) in Participants With Human Immunodeficiency Virus (HIV)-1 Who Are Virologically Suppressed.
• GSK3640254 study: A Phase IIb, randomized, partially blind, active controlled, dose-range finding study of GSK3640254 compared to a reference arm of dolutegravir, each in combination with nucleoside reverse transcriptase inhibitors, in HIV-1 infected antiretroviral treatment-naive adults.
• MK-8591-013 study: A Phase 2b, Randomized, Active-Controlled, Double-Blind, Dose-Ranging Clinical Study to Evaluate a Switch to Islatravir (ISL) and MK-8507 Once-Weekly in Adults with HIV-1 Virologically Suppressed on Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF) Once-Daily.
• MK-8591A-17 study: A Phase 3 randomized, active-controlled, open-label clinical study to evaluate a switch to doravirine/islatravir (DOR/ISL) once daily in participants with HIV-1 virologically suppressed on antiretroviral Therapy.
• SwissPrEPared Study”: A multicenter, observational cohort to study the characteristics of individuals asking for pre-exposure prophylaxis (PrEP) and the incidence of HIV and other STIs.

Ongoing cohort studies

The Swiss HIV Cohort Study (SHCS)

The Swiss HIV Cohort Study (SHCS) is a clinic based, multicenter longitudinal study enrolling HIV-infected women and men of all transmission routes. The study is active in research in clinical HIV medicine and in the field of basic, social and preventive sciences.  It was started in 1988 and enrolls > 19’000 patients. The SHCS is instrumental for the high quality of care that HIV-medicine has achieved in Switzerland and in general for a better understanding of the virus – host interactions between HIV and the human body. (www.shcs.ch). To date, several research projects are ongoing in the SHCS, including antiretroviral therapy simplification trials, assessment of HIV-related stigma, investigating the interplay between HIV and tuberculosis.

The Zurich Primary HIV-Infection study (ZPHI)

The ZPHI is an ongoing, investigator initiated, multi-center trial conducted at the University Hospital Zurich (USZ). The ZPHI is the main basis for various national and international research projects. ZPHI Study cohort focuses on a unique patient population that is difficult to identify and recruit, namely patients with acute or recent HIV-1 infection. Acutely infected and early ART treated individuals represent one of the key target populations for proving HIV-1 eradication strategies as they have due to the early onset of ART a low latent reservoir which is the optimal setting for eradication interventions to be successful. The ZPHI recruits these individuals upon diagnosis of HIV-1 infection and has to date enrolled more than 450 individuals with a documented acute or recent HIV-1 infection. The ZPHI participants are followed longitudinally at trimonthly clinical visits. Clinical and demographic data alongside a wide spectrum of investigative measurements are collected.

Swiss PrePared Study

The SwissPrEPared study is a nation-wide program for surveillance and for exchanging experiences related to HIV pre-exposure prophylaxis (PrEP) consultations. The goal is to ensure best care for individuals seeking for PrEP. Data generated by the study will be used to explore specific research questions in the context of PrEP. Ultimately, the ‘SwissPrEPared’ program prepares the ground for a broader strategy directed at stopping the HIV epidemic in Switzerland, thereby meeting the “90-90-90” UNAIDS target*. The ultimate goal is HIV elimination in Switzerland i.e. no new infections.