THE ANRS& research in resourcelimited settings

Transcription

1 THE ANRS& research in resourcelimited settings \1

2 2 / THE ANRS& research in resourcelimited settings

3 \ The ANRS: commited to resource-limited countries and the developed world Funding of research proposals The ANRS sites: a partnership at the heart of research between the developed world and resource-limited countries Managing research in resource-limited countries The main lines of research in resource-limited countries Ethics and good research practice ANRS Research in resource-limited settings department Bibliographic references Map of partner countries The ANRS sites The Burkina Faso site The Cameroon site The Côte d Ivoire site The Senegal site The Cambodia site The Vietnam site The Egypt site The Brazil site Ongoing projects

4 / 4 The ANRS: commited to the resource-limited countries and the developed world n Since 1992, the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) has been executing, coordinating and funding research on HIV/AIDS and, since 2003, on viral hepatitis, in France and in countries with limited resources. Its annual budget, comprising mainly public funding, amounts to approximately 44 million euros. Annual budget of the ANRS: approximately 44 million euros 1992 Creation of the French Agency for AIDS Research 1999 n Despite the progress made in the fight against these two epidemics, UNAIDS estimates that approximately 35 million adults and children around the world are infected by the AIDS virus. More than 240 million people are infected by the hepatitis B virus and 184 million by the hepatitis C virus. This is a global public health problem that spares neither the developed world nor resource-limited countries. This is why the ANRS supports research in both the developed world and in resource-limited settings and every year earmarks over 20% of its budget for countries with limited resources. Funding of research proposals n ANRS calls for research Two annual calls for research proposals (January and June) are open to all public or private research laboratories, whatever their field of research. proposals open to resourcelimited countries n First proposal funded: ANRS DITRAME PLUS ANRS scope extended to viral hepatitis 2012 The ANRS became an autonomous agency of Inserm Proposals for research in countries with limited resources must include at least one French team and one relevant team from the country or countries where the research will be conducted. n Proposals are reviewed by an ANRS independent and multidisciplinary scientific committee (CSS6) comprising 15 French and foreign researchers and clinicians from the developed world and from resource-limited settings1. Representatives of patient groups from resource-limited settings and the developed world are also voting members. n Between 2011 and 2013, on average, 30% of proposals submitted to the ANRS were funded2. 2e APP APPEL PEL À PRO PROJETS OJETS TS P ROJETS D E RECHERCHE, CONTRA INITIA UNE RECHERCHE, PROJETS DE CONTRATS NTRA ATS TS D D INITIATION IA ATION D D UNE A LLOCA ATIONS D E RECHERCHE, COLLOQ UES ET P UBLICA ATIONS ALLOCATIONS DE COLLOQUES PUBLICATIONS 2013 A new identity for the ANRS and a new logo DOMAINES DOMAINE S DE DE RECHERCHE ERCHE : ENSEMBLE D DES ES RECHERCHES S SUR UR LE V VIH/SIDA IH/SIDA ; RECHERCHES S SUR UR D D AUTRES AUTRES THÉMA THÉMATIQUES TIQ TIQ I UES D DÈS ÈS LORS Q QU ELLES U ELLES SONT U UTILES TILES DE PHYSIOPATHOLOGIE DE PAR À LA COMPRÉHENSION D E LA PHYSIOP ATTHOLOGIE OLOGIE D E LL INFECTION INFECTION INFECTION P A AR LE VIH. VIH. H ENSEMBLE DES DES RECHERCHES SUR SUR LES V HÉPATITES É ATITES IRUS D ES HÉPA ENSEMBLE VIRUS DES VIH/HÉPA ATITES. ET LES CO-INFECTIONS VIH/HÉPATITES. INFORMATIONS INFORMA ATIONS ET FORMULAIRES FORMULAIRES SUR SUR www s.frr Utiliser impérativement les formulaires du 2e appel à projets 2014 L appel à projets est ouver ouvertt à tout laboratoire de rec recherche, herche, public ou pri privé vé 1. Proposals concerning cohort follow-up studies are reviewed by a specific evaluation committee. 2. The complete list of ongoing projects funded by the ANRS can be found on pages 30 to ANRS DITRAME PLUS-1. Evaluation of peripartum interventions in prevention of mother-to-child HIV transmission in Africa.

5 \5 The ANRS sites: a partnership at the heart of research between the developed world and resource-limited countries Africa, Southeast Asia, Egypt, and Brazil Sustained support in personnel, equipment, and buildings n The Research Agency ANRS (France Recherche Nord&Sud Sida- HIV Hépatites) concentrates its human and financial resources in its country sites 4 : in Africa: Côte d Ivoire, Senegal, Burkina Faso, Cameroon in Southeast Asia: Vietnam and Cambodia Egypt Brazil. n In partnership with national health and research authorities, the ANRS sites 5 are placed under the joint responsibility of a coordinator from the developed world and a coordinator from a resource-limited country who in collaboration define the key lines of research. The ANRS sites facilitate the establishment of research programs between: national institutions of the partner countries (university hospitals, laboratories and research centers, local Institut Pasteur, national AIDS programs ), French research organizations like the Research Development Institute (IRD), the National Institute of Health and Medical Research (Inserm), the National Center for Scientific Research (CNRS), the Institut Pasteur network, universities, the Network for Therapeutic Solidarity in Hospitals (Esther), institutions in other countries (National Institutes of Health, Centers for Disease Control, United States, London School of Hygiene and Tropical Medicine, United Kingdom ), - international institutions (World Health Organization, European & Developing Countries Clinical Trials Partnership ). n ANRS provides its sites with sustained support in personnel, laboratory equipment, and buildings. n Scientific days are held regularly at each site. They offer an opportunity for ANRS managers and researchers, clinicians, civil society representatives, national authorities, and the press, to discuss how projects are moving forward, the results obtained, and future perspectives. n About 70% of the budget that the ANRS allocates to countries with limited resources is earmarked for research at the sites, 30% being allotted to projects conducted off-site, mainly in Africa. 4. Map of sites, pages Site activities, pages 14 to 29.

6 6 / Managing research in resourcelimited countries Defining emerging research areas n The Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) coordinated action "Research in resource-limited countries" (AC12) covers scientific and strategic research in these countries 6. n AC12, which comprises coordinators from the developed world and from ANRS sites and experts in various fields, defines emerging areas of research. n Several multidisciplinary working groups draw up proposals in these areas and support the creation of networks between countries with limited resources. The main lines of research in resource-limited countries Supporting the creation of networks between resource-limited countries Antiretrovirals for adults: early treatment of adults, management of patients in whom first and second-line antiretroviral treatment has failed, evaluation of WHO recommendations, prevention and treatment of opportunistic infections (cryptococcosis ). Tuberculosis and HIV co-infections: search for the best therapeutic strategies using combinations of antiretrovirals and tuberculosis drugs, prevention of tuberculosis in HIV-positive patients. Prevention of mother-to-child HIV transmission and pediatric research: transmission of HIV in breast milk and early treatment of the child, comparison of treatment regimens in children, long-term effect of antiretrovirals. Viral resistance in countries with limited resources: collaboration with the WHO in national programs on monitoring resistance in untreated subjects and in patients on antiretrovirals. Alternative techniques in virology: development and quality control of low-cost virological tests. Prevention of sexual transmission of HIV: clinical and social sciences research on prevention, mostly in the biomedical field (circumcision, peri-exposure prophylaxis, treatment as prevention ). Social sciences and health economics research: screening and access to healthcare, experience of living with the disease, public epidemic control policy, drug policy, pharmaceutical market Hepatitis: hepatitis C and hepatitis B-HIV co-infections, prevention of HIV infection and viral hepatitis in drug users. 7. President of the AC12: François Dabis, Inserm U897, Université Victor Segalen, Bordeaux

7 \7 Ethics and good research preactice Since 2002, the ANRS has a charter of ethics and good research practice which is applied in countries with limited resources and serves as the reference for all researchers seeking to conduct an ANRS-funded project in such countries. The key principles of the ANRS Ethics Charter for research in developing countries are as follows: The notion of partnership between the developed world and resource-limited countries in all fields: composition of committees (evaluation committee, working groups) and teams responsible for research, collaboration with national public health programs on the definition of research priorities, delivery of results in the corresponding country. Protection of human research participants. ANRS assumes its responsibilities as sponsor and has taken out a civil liability insurance to cover all patients participating in biomedical research. An independent monitoring committee evaluates the adherence to ethical principles during research, the application of good practice guidelines, and the validity of certain results. The ANRS ensures medical management of patients throughout the research and a commitment by the national authorities is required for follow-up treatment after every trial. The increased role of viral hepatitis research and changes in resourcelimited settings in terms of the ethics of research and the protection of participants are such, that the ANRS anticipates a revision of its charter in the medium term. To ensure that the optimal conditions for the implementation of research are respected ANRS Research in resource-limited settings department A team of six people oversees: the science policy and general strategy for all research conducted in resource-limited settings, the organization and implementation of the research projects, the coordination of activities, and the management of the sites. It also provides scientific and administrative support for the research teams. 7. The ethics charter covering research in developing countries (2008 update) is available on the ANRS website: Contact : Brigitte Bazin Director of the Research in resource-limited settings department Tél. : + 33 (0) [email protected] November 2008 November 2008 Ethics charter Ethics charter for research in developing countries for research in developing countries W RITTEN M AY 2002 AND AMENDED O C T O B E R 2008 W RITTEN M AY 2002 AND AMENDED O C T O B E R 2008 I GENERAL PRINCIPLES I GENERAL PRINCIPLES 1.1 Adherence to texts page A top priority: improving the health of populations page Partnership and cooperation page Adherence to texts page A top priority: improving the health of populations page Partnership and cooperation page 5

8 8 / 1999 Preventive treatment Cotrimoxazole prophylaxis of opportunistic infections at the first stages of HIV infection Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d Ivoire : a randomized trial. Cotrimo-CI Study Group. Anglaret X, Chene G, Attia A, Toure S, Lafont S, Combe P, Manlan K, N Dri-Yoman T, Salamon R. Lancet 1999; 353 (9163); (ANRS 059) Bibliographic references Origin of the virus 2001 The history of transmission of HIV-1 Dating the common ancestor of SIVcpz and HIV-1 group M and the origin of HIV-1 subtypes using a new method to uncover clock-like molecular evolution. Salemi M, Strimmer K, Hall WW, Duffy M, Delaporte E, Mboup S, Peeters M, Vandamme AM. FASEB J. 2001; 15 (2): Epub 2000 Dec 8. Treatments 2004 Efficacy of a generic combination for first-line treatment in Africa Effectiveness and safety of a generic fixed-dose combination of nevirapine, stavudine, and lamivudine in HIV-1-infected adults in Cameroon : open-label multicentre trial. Laurent C, Kouanfack C, Koulla-Shiro S, Delaporte E, for the ANRS 1274 study group (2004). The Lancet 2004; 364 (9428): (ANRS 1274) Biomedical prevention 2005 Male circumcision greatly reduces (60%) the risk of HIV transmission to men Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk : The ANRS 1265 Trial. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, et al. PLoS Med. 2005; 2 (11): e298 (ANRS 1265)

9 \9 Origin of the virus 2006 The gorilla (DRC) is the natural reservoir of HIV-1 group O Human immunodeficiency viruses : SIV infection in wild gorillas. Van Heuverswyn F, Li Y, Neel C, Peeters M. Nature 2006; 444 (7116): 164 (ANRS 12125) Treatments 2007 Valaciclovir reduces genital viral load of HIV-1 in women with HIV- 1/HSV-2 co-infection Reduction of HIV-1 RNA Levels with Therapy to Suppress Herpes Simplex Virus. Nagot N, M.D., Ouédraogo A, Foulongne V, Van de Perre P, Mayaud P, for the ANRS 1285 Study Group. N Engl J Med. 2007; 356: (ANRS 1285) Mother-to-child transmission 2005 Short zidovudine treatment and single-dose nevirapine effectively reduce mother-to-child HIV transmission Field efficacy of zidovudine, lamivudine and single-dose nevirapine to prevent peripartum HIV transmission. Dabis F, Bequet L, Koumavi Ekouevi D, Leroy V. AIDS 2005; 19 (3): (DITRAME ANRS 1201) Origin of the virus 2006 The chimpanzee subspecies Pan troglodytes troglodytes (Cameroon) is the natural reservoir of HIV-1 strains M and N Chimpanzee Reservoirs of Pandemic and Nonpandemic HIV-1. B F Keele, Van Heuverswyn F, Li Y, Peeters M and H Hahn B. Science 2006; 313 (5786): Treatments 2011 Efficacy of early antiretroviral treatment of patients co-infected with HIV and tuberculosis Earlier versus later start of antiretroviral therapy in HIVinfected adults with tuberculosis. Blanc FX, Sok T, Laureillard D, Borand L, Goldfeld AE. N Engl J Med. 2011; 365 (16): (ANRS 1295)

10 10 / Mother-to-child transmission 2011 Efficacy of triple antiretroviral therapy in reducing the risk of mother-to-child transmission Triple antiretroviral compared with zidovudine and singledose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study) : a randomised controlled trial. The Kesho Bora Study Group. Lancet Infect Dis. 2011; 11 (3); (ANRS 1289 Kesho Bora) Management 2012 Morbidity and mortality of patients before initiating ARV treatment, stratified by CD4 counts AIDS and non-aids morbidity and mortality across the spectrum of CD4 cell counts in HIV-infected adults before starting antiretroviral therapy in Cote d Ivoire. Anglaret X, Minga A, Gabillard D, Ouassa T, Messou E, Morris B, Traore M, Coulibaly A, Freedberg KA, Lewden C, Menan H, Abo Y, Dakoury- Dogbo N, Toure S, Seyler C. Clin Infect Dis. 2012; 54 (5): (ANRS Morbidity/Mortality STU) Management 2012 Clinical monitoring alone versus monitoring of viral load and CD4 cell counts in Cameroon Monitoring of HIV viral loads, CD4 cell counts, and clinical assessments versus clinical monitoring alone for antiretroviral therapy in rural district hospitals in Cameroon (Stratall ANRS 12110/ESTHER) : a randomised non-inferiority trial. Laurent C, Kouanfack C, Laborde-Balen G, Aghokeng AF, Mbougua JB, Boyer S, Carrieri MP, Mben JM, Dontsop M, Kaze S, Molinari N, Bourgeois A, Mpoudi-Ngole E, Spire B, Koulla-Shiro S, Delaporte E. Lancet Infect Dis. 2012; 11 (11); (ANRS STRATALL) HIV/tuberculosis co-infection 2012 Association between natural killer cell degranulation and risk of immune reconstitution inflammatory syndrome in patients co-infected with HIV and tuberculosis Natural killer cell degranulation capacity predicts early onset of the immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients with tuberculosis. Pean P, Nerrienet E, Madec Y, Borand L, Laureillard D, Fernandez M, Marcy O, Sarin C, Phon K, Taylor S, Pancino G, Barré-Sinoussi F, Scott-Algara D. Blood 2012; 119 (14); (ANRS 1295 CAMELIA) Treatments 2013 Use of nevirapine as an alternative to efavirenz in patients co-infected with HIV and tuberculosis Nevirapine versus efavirenz for patients co-infected with HIV and tuberculosis : a randomised non-inferiority trial. Bonnet M, Bhatt N, et al. (ANRS CARINEMO). Lancet Infect Dis. 2013; 13 (4);

11 2/03/10 10:09 Page 1 Sous la direction de Fred Eboko Claude Abé Christian Laurent Sous la direction de Alice Desclaux Philippe Msellati Khoudia Sow \ The Political Economy of HIV/AIDS in Developing Countries. Trips, public Health Systems and Free Access. Benjamin Coriat (Edited by), Edward Elgar Publishing Ltd, 2008, 384 p. Reference works on social sciences research 2010 Accès décentralisé au traitement du VIH/sida. Évaluation de l expérience camerounaise. Fred Eboko, Claude Abé, Christian Laurent. ANRS, Collection Sciences sociales et sida, 2010, 324 p. Collection Sciences sociales et sida Accès décentralisé au traitement du VIH/sida Évaluation de l expérience camerounaise 2011 Les femmes à l épreuve du VIH dans les pays du Sud. Genre et accès universel à la prise en charge. Alice Desclaux, Philippe Msellati, Khoudia Sow. ANRS, Collection Sciences sociales et sida, 2011, 555 p. Collection Sciences sociales et sida Les femmes à l épreuve du VIH dans les pays du Sud Genre et accès universel à la prise en charge more at [ ] Collection Sciences sociales et sida 2012 From collaborative research to community-based research. A methodological toolkit. Élise Demange, Émilie Henry, Marie Préau. ANRS, Collection Sciences sociales et sida, 2012, 211 p. From collaborative research to community-based research A methodological toolkit Elise Demange Emilie Henry Marie Préau These publications can be accessed on the ANRS website: Accès aux antirétroviraux dans les pays du Sud. Propriété intellectuelle et politiques publiques. Cristina Possas, Bernard Larouzé. ANRS, Collection Sciences sociales et sida, 2013, 272p.

12 12 / Partner countries Canada Norway United Kingdom Belgium France United States Morocco Dominican Republic Suriname Senegal Guinea Côte d Ivoire Mali Burkina Faso Togo Republic of Brazil Partner countries-sites in resource-limited settings Partner countries in resource-limited settings Partner countries in the developed world

13 \13 n Concentration of means at 8 country sites n One third of the budget for limited-resource settings devoted to 19 other countries n Collaboration with 9 countries in the developed world Germany Luxembourg Switzerland Georgia Cameroun Democratic Republic of Congo Gabon the Congo Egypt Central African Republic Uganda Burundi India Cambodia Laos Vietnam Zambia Malawi Madagascar South Africa

14 14 / Burkina Faso SITE The Muraz Center at Bobo-Dioulasso. The site The site was created in Historically, it was structured around the Muraz Center, a multidisciplinary research facility that became a Burkina Faso public institution in 2001 (HIV/AIDS, malaria, tuberculosis). In this setting, the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) provided the Muraz Center with equipment and with reception facilities for the recruitment and followup of cohorts, a molecular virology laboratory (biosafety level 2), and an immunology laboratory. A computing, methodological and statistical (IT center) resources center was built there by the ANRS and inaugurated in A second research center was developed at Ouagadougou in the Health Sciences Faculty, at the International Health Research Center of the University of Ouagadougou. Areas of research Above, the Charles-de- Gaulle Hospital in Ouagadougou. Below, the Internal Medicine Department of the Yalgado Ouédraogo Hospital in Ouagadougou. The main area of research at the site is the prevention and treatment of HIV infection in women and children. Since its creation, the site has developed clinical research programs comprising clinical trials on prevention of mother-to-child HIV transmission (particularly through breastfeeding) and antiretroviral treatment of children. Social sciences and public health research relates to anthropological analysis of clinical trials, how children experience the disease and how it is treated, and to the study of the social and economic conditions of access to healthcare for women living with AIDS. Lastly, laboratory research is being conducted on the immunological and virological determinants of HIV transmission (sexual and mother-to-child), resistance to antiretrovirals, and the impact of HIV/tuberculosis coinfection on the dynamics of the HIV epidemic. Between 1998 and 2010, studies of a cohort of vulnerable women (Cohort Yerelon-ANRS 1222) yielded various publications and enabled investigation of the immunological and virological mechanisms of viral interactions, notably between HIV and the herpes virus. Also, a program on viral hepatitis is under way consisting of the followup of a cohort of children infected by hepatitis B virus, using a realtime in-house PCR method to detect and quantify hepatitis B viral DNA in serum.

15 \15 PARTNERS IN BURKINA FASO n Centre hospitalier universitaire pédiatrique Charles-de-Gaulle de Ouagadougou n Centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou n Comité ministériel de lutte contre le sida du secteur santé (CMLS/Santé) n Conseil national de lutte contre le sida (CNLS-IST) n Direction régionale de la Santé du Centre à Ouagadougou n Direction de la Santé de la famille (DSF) du ministère de la Santé n Groupe de recherche action en santé (GRAS) n Université de Ouagadougou n Université de Ouagadougou, unité de formation et de recherche en sciences de la santé (UFR-SDS) PARTNERS IN FRANCE AND IN EUROPE n Centre hospitalier universitaire Arnaud de Villeneuve, Montpellier n Centre hospitalier universitaire du Luxembourg, CRP-Santé, Luxembourg n Faculté de médecine Paris-Descartes n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Hôpital Cochin, Paris n Hôpital Necker, Paris n Hôpital universitaire des enfants de la reine Fabiola, Belgique n Institut de médecine tropicale d Anvers, Belgique n Institut national de la santé et de la recherche médicale (Inserm) n Institut Pasteur n Institut de recherche pour le développement (Ird) n Université Montpellier 1 Developed world coordinator Pr PHILIPPE VAN DE PERRE Inserm U1058 «Infection par le VIH et par agents à tropisme cutanéo-muqueux : de la pathogénèse à la prévention» Département de bactériologie-virologie CHU Arnaud de Villeneuve 371, avenue du doyen Gaston-Giraud Montpellier cedex 5 France [email protected] Resource-limited setting coordinator Pr NICOLAS MEDA Centre Muraz/Ministère de la Santé 2054, avenue Mamadou Konate 01 BP 390 Bobo-Dioulasso 01 Burkina Faso [email protected] UFR Sciences de la Santé CRIS/Site ANRS Burkina Université de Ouagadougou 09 BP 168 Ouagadougou 09 Burkina Faso [email protected]

16 16 / Cameroon SITE Opposite, the ANRS site, Yaounde Central Hospital. Below, a view of Yaounde. The site Historically, the site was set up through a strong partnership developed by the «Centre IRD de Montpellier». Collaborations between Cameroonian and French teams started in 1999 through the creation of a research site set up and equipped by the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) on the grounds of the Yaounde Central Hospital. This collaboration was formalized in 2005 by a tripartite agreement between the Cameroonian Health and Research Ministries and the ANRS. The Centre Pasteur of Cameroon is an essential partner in research conducted at the site. Areas of research Research currently under way at the site relating to HIV infection: virology (origin and transmission of the virus from monkeys to humans, resistance and genetic diversity of different types of HIV), clinical research trials to evaluate new treatment strategies in adults, the clinical and psychosocial impact of early multidrug therapy in children, and opportunistic infections (cryptococcosis). Research on viral hepatitis is also carried out onsite: studies on the prevalence and treatment evaluations for hepatitic C. A large public health and social sciences research program, set up at the request of the Ministry of Health, is analyzing the political, economic, and social aspects of upscaling and decentralization of access to antiretroviral therapy in Cameroon, and the history of public policies for epidemic control.

17 \17 PARTNERS IN CAMEROON n Centre hospitalier de Yaoundé n Centre hospitalier de Douala n Centre Pasteur du Cameroun n Clinique de la Cathédrale (TAC) n École nationale supérieure polytechnique n Fondation Paul Ango Ela de géopolitique en Afrique centrale n Hôpital central de Yaoundé n Laboratoire mixte de l Institut de recherches médicales et d études des plantes médicinales (IMPM) Centre de recherche sur les maladies émergentes et réémergentes (Cremer) Institut de recherche pour le développement (IRD) n SCAC/Ambassade de France n Université catholique d Afrique centrale n Universités de Yaoundé I et II PARTNERS IN FRANCE n Centre hospitalier universitaire de Montpellier n Centre hospitalier universitaire de Rouen n Centre national de la recherche scientifique (CNRS) n Faculté de médecine Paris-Descartes n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Institut de médecine et d épidémiologie appliquée (IMEA) n Institut national de la santé et de la recherche médicale (Inserm) n Institut Pasteur n Institut de recherche pour le développement (IRD) Developed world coordinator Pr ÉRIC DELAPORTE UMI 233 «TransVIHMI» Centre IRD de Montpellier 911, avenue Agropolis BP Montpellier cedex 5 France [email protected] Resource-limited settings coordinator Pr SINATA KOULLA-SHIRO Service des maladies infectieuses Hôpital central de Yaoundé et faculté de médecine et des sciences biomédicales de l université de Yaoundé I BP Yaoundé Cameroun [email protected]

18 18 / Côte d Ivoire SITE Above, the Public Health Unit, Treichville Hospital, Abidjan. Below, the Treatment and Training Center (CePReF) in Yopougon, Abidjan. The site Site PAC-CI ANRS, Treichville Hospital, Abidjan. The PAC-CI/ ANRS Côte d Ivoire site program was set up in 1994 and formalized in 1996 by an agreement between the Côte d Ivoire Ministry of Public Health, ANRS, and the French Ministry of Foreign Affairs. This agreement set forth two goals: the training of healthcare personnel in medical research on HIV/AIDS and the implementation of HIV/AIDS research of interest for the general population. The agreement was renewed in 2010 and extended to include three new signatories: in Côte d Ivoire, the Ministry of Higher Education and Research, and in France, Inserm and Bordeaux Segalen University. Within this framework there is a plan to set up an Inserm international associated laboratory. The Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) has supported the establishment and equipping of laboratories for molecular virology, parasitology, bacteriology, and immunology, and the creation of reception facilities at several sites in Abidjan. The ANRS has also constructed a building dedicated to the coordination of the site s research programs and activities, within the grounds of the Treichville University Hospital. Areas of research The site's main lines of research are the improvement in care of infected adults and amelioration of treatment of children living with HIV. Research on these subjects relates above all to clinical questions on the management of HIV-positive patients at all stages of the disease: early treatment, treatment of patients who have experienced first and second-line treatment failure, evaluation of new drugs and strategies, treatment of patients infected by HIV-2. A cohort of patients of known date of infection has been in place for a number of years. Lastly, a clinical trial on treatment of hepatitis C virus infection will start soon. In laboratory work, studies on virus quantification and viral resistance to antiretrovirals are prioritized. Research is conducted by multidisciplinary teams including clinicians, laboratory technologists, epidemiologists, statisticians, economists, modelers, sociologists, and anthropologists.

19 \19 PARTNERS IN CÔTE D IVOIRE n Centre hospitalier universitaire de Treichville n Centre hospitalier universitaire de Yopougon n Centre intégré de recherches biocliniques à Abidjan (CIRBA) n Centre national de transfusion sanguine (CNTS) n Centre de prise en charge et de formation (CePReF) n École nationale supérieure de statistique et d économie appliquée (ENSEA) d Abidjan n Unité de soins ambulatoires et de conseil (USAC) n Université d Abidjan-Cocody (Institut d Ethno-sociologie, GIRFOS-CI) n Université de Bouaké, laboratoire de sociologie du développement PARTNERS IN FRANCE, GERMANY, AND THE UNITED STATES n Centre hospitalier universitaire de Bordeaux n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Hôpital Necker, service de virologie, Paris n Hôpital Saint-Louis, Paris n Hôpital Saint-Antoine, Paris n Institut national de la santé et de la recherche médicale (Inserm) n Institut de recherche pour le développement (IRD) n Munich University Hospital, Germany n University of Harvard (CEPAC), United States Developed world coordinator Dr XAVIER ANGLARET Inserm U897, Université Bordeaux Segalen Bordeaux cedex France [email protected] [email protected] Resource-limited settings coordinator Pr THÉRÈSE N DRI YOMAN Service de gastro-entérologie, CHU de Yopougon 08 BP 412, Abidjan 08 Côte d Ivoire [email protected] Programme PAC-CI/site ANRS 18 BP 1954, Abidjan 18 Côte d Ivoire [email protected]

20 20 / Senegal SITE The site The Regional Center for Research and Training in HIV/AIDS Treatment (CRCF), Fann National University Hospital, Dakar. Created in 1990, the site has its foundations on a close partnership with the National AIDS Control Committee (CNLS). Since 2005, the creation of the Regional Center for Research and Training in HIV/AIDS Treatment (CRCF) in the Fann National University Hospital has facilitated the organization of clinical research, strengthened training programs, and improved treatment of people living with HIV/AIDS. The Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) provides funds for infrastructure, equipment (real-time PCR, sequencers), and staffing at the National Virology Laboratory at the Le Dantec Hospital, and at the Fann National University Hospital (consultation center, social services, pharmacy, analytical laboratory, clinical trial management center, IT department, etc.). Areas of research The vegetable garden of the Infectious Diseases Department, Fann National University Hospital, Dakar. Onsite research is focused in particular on clinical research: randomized, multicenter clinical trials on antiretroviral treatment in treatment-naive patients and antiretroviral treatment failure patients, trials on new drugs for treatment of hepatitis C in monoinfected and co-infected patients, and a cohort of children and adolescents infected by HIV. In the field of social sciences and public health, ongoing studies are considering the risk and prevention of HIV transmission, notably in the vulnerable populations of male homosexuals and injecting drug users, the assessment of the cost-effectiveness of second-line treatments, the social determinants of treatment failures, the conditions of assisted reproduction in the context of HIV infection, the experience of treatment and its relation to gender, and the consequences of the adverse effects of treatments. Following several studies of the genetic diversity of HIV and its implications, current research in virology is focusing on resistance to antiretrovirals and on the immunological and virological efficacy of different therapeutic strategies. Along with the other ANRS sites, the Senegal site is implementing in the ANRS quality policy by recording quality indicators for clinical trials, strengthening research ethics through community participation, training, and respecting good clinical practice.

21 \21 PARTNERS IN SENEGAL n Centre hospitalier national universitaire de Fann n Centre de recherche et de formation sur la prise en charge du VIH/sida (CRCF) n Hôpital Le Dantec, Dakar n Hôpital Principal, Dakar n Université Cheikh Anta Diop, Institut de recherche et d études psychopathologiques (IREP) n Université Cheikh Anta Diop, faculté de médecine PARTNERS IN FRANCE n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Hôpital Saint-Antoine, Paris n Institut Pasteur n Institut de recherche pour le développement (IRD) n Institut de médecine et d épidémiologie appliquée (IMEA) n Union européenne Developed world coordinator Dr BERNARD TAVERNE UMI 233 «TransVIHMI» Institut de Recherche pour le Développement (IRD) 911, avenue Agropolis BP Montpellier cedex 5 France [email protected] Resource-limited settings coordinator Dr IBRA N DOYE Président du Conseil d'administration du CRCF Centre hospitalier national universitaire de Fann BP Dakar Sénégal [email protected] [email protected] Website :

22 22 / The Institut Pasteur of Cambodia in Phnom Penh. Cambodia SITE The site The ANRS site in Cambodia was officially created on 4 January 2000 through an agreement signed between the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites), the French Embassy, and the Cambodian Ministry of Health. The site is supported by the Institut Pasteur of Cambodia (IPC), a member of the Institut Pasteur international network, and the National Center for HIV/AIDS, Dermatology and Sexually Transmitted Diseases (NCHADS). There is a department that manages methodology and clinical research in the Epidemiology and Public Health Unit of the IPC. The virology, immunology, and bacteriology laboratories actively participate in research. The ANRS has funded diagnostic equipment and instruments for use in research in immunology (CD4 flow cytometer, ispot FluoroSpot Reader), virology (MagNA Pure LC, real-time PCR), and tuberculosis (Bactec MGIT). Areas of research Early research at the site focused on prevention of mother-to-child HIV transmission. Current research is mainly clinical, with trials on antiretroviral therapy in adults and children co-infected with HIV and tuberculosis, mainly regarding the evaluation of diagnostic techniques in children and, the best tuberculosis prevention and/or treatment strategies in adults. The site is also developing basic research in virology (viral load-genotyping of resistance to antiretrovirals) and immunology (role of natural killer cells and T cells).

23 \23 PARTNERS IN CAMBODIA n Cambodian Health Committee (CHC) n Center for Khmer Study n La Croix Rouge française à Phnom Penh n Fondation Mérieux à Phnom Penh n Hôpital Calmette n Institut Pasteur du Cambodge n Institut de recherche pour le développement (IRD) à Phnom Penh n Kantha Bopha Hospital et Angkor Children Hospital à Siem Reap n Khmero Soviet Friendship Hospital n Kossamak Hospital n Magna n Médecins sans Frontières (France) à Phnom Penh, à Siem Reap et à Takeo n National Pediatric Hospital n Provincial Hospitals (Kompong Cham, Siem Reap, Svay Rieng, Takeo) n Royal University of Phnom Penh, department of Sociology-Anthropology n University of Health Sciences PARTENAIRES EN FRANCE ET AUX ÉTATS-UNIS n Centre hospitalier régional universitaire Arnaud de Villeneuve, Montpellier n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Harvard Medical School, United States n Hôpital La Pitié-Salpêtrière, Paris n Hôpital du Kremlin-Bicêtre n Hôpital Necker, Paris n Institut national de la santé et de la recherche médicale (Inserm) n Institut Pasteur n Institut de recherche pour le développement (IRD) n NIH (National Institutes of Health), United States Developed world coordinator Dr ISABELLE FOURNIER Inserm SC10-US019 Bâtiment 15/16 Hôpital Paul-Brousse Villejuif cedex [email protected] Resource-limited settings coordinator Dr SAPHONN VONTHANAK Deputy director of National institute of health Chief of the Research unit of NCHADS (National Center HIV/AIDS, Dermatology and STD) #245H, National Road 6A, Sangkat Prek Leap Khan Rusey Keo, Phnom Penh Cambodia [email protected] [email protected]

24 24 / The Institut Pasteur in Ho Chi Minh City. Vietnam SITE The site Relations between teams of French and Vietnamese researchers started in A first collaboration agreement was signed in 1995, and then, on 6 January 2000, the ANRS site of Vietnam was officially created. Most of the studies funded by the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) are conducted in Ho Chi Minh City, with the support of the Institut Pasteur and the city s hospitals, with in the framework of national (VAAC) and provincial (PAC) AIDS control programs. The studies now extend to the north of Vietnam, notably Hanoi and Hai Phong. The work is conducted by teams of clinicians, virologists, microbiologists, immunologists, and human and social science researchers. Above, the Pham Ngoc Thach Hospital in Ho Chi Minh City. Below, brochure published for the tenth anniversary of the ANRS-Southeast Asia collaboration. Areas of research The site's research activity began with projects focusing on virology (genetic variability) and molecular epidemiology (resistance to antiretrovirals). Clinical research has mainly focused on the treatment of adults co-infected with HIV and tuberculosis. One of two complementary trials on HIV/tuberculosis co-infection will explore the routine empirical treatment of tuberculosis before initiation of antiretroviral treatment, in HIV-infected patients. The other trial will study an alternative antiretroviral strategy in the patients co-infected with HIV and tuberculosis. Work is also being conducted on the question of HIV/tuberculosis co-infection in children, focusing on the evaluation of different methods of diagnosing tuberculosis. A pilot study of the treatment of patients infected by the hepatitis C virus is also planned. The ANRS has equipped the site with real-time PCR apparatus and has developed a method suited to the strains circulating in Asia. Multidisciplinary research supporting the Vietnamese government s initiative to reduce the risk of HIV infection among intravenous drugs users is mainly investigating the characteristics and outcomes of HIV and hepatitis infected patients.

25 \25 PARTNERS IN VIETNAM n Children s Hospital no. 1 (Nhi Dong 1) n Children s Hospital no. 2 (Nhi Dong 2) n The Hospital for Tropical Diseases n Institut Pasteur in Ho Chi Minh City n Institute for Population and Social Studies, National Economics University n National Hospital of Pediatrics n Pham Ngoc Thach Hospital n Provincial AIDS Committees (PAC) n Vietnamese Academy of Social Sciences, Southern Institute of Social Sciences PARTNERS IN FRANCE n GIP Esther (Ensemble pour une solidarité thérapeutique hospitalière en réseau) n Hôpital européen Georges-Pompidou à Paris n Hôpital Henri Mondor, Créteil n Hôpital du Kremlin-Bicêtre n Hôpital Necker, Paris n Hôpital Saint-Antoine, Paris n Institut national de la santé et de la recherche médicale (Inserm) n International Union Against Tuberculosis and Lung Disease (IUATLD) Developed world coordinator Pr FRANÇOISE BARRÉ-SINOUSSI Institut Pasteur Département de virologie Unité de régulation des infections rétrovirales 25, rue du Docteur-Roux Paris cedex 15 France [email protected] Resource-limited settings coordinator Dr TRUONG XUAN LIEN Institut Pasteur de Hô Chi Minh Ville 167, rue Pasteur, 3 e Arr. Hô Chi Minh Ville Vietnam [email protected]

26 26 / Egypt SITE The Imbaba Fever Hospital in Cairo. The site Below, the Medical Faculty, Ain Shams University, Cairo. A multidisciplinary French-Egyptian network including the Pasteur Institute in Paris and several research institutions and universities in Cairo has been working on hepatitis C in Egypt since This collaboration led to the creation of the ANRS site in Research work is organized around two study sites: a cohort in a rural setting, at Zawiat Razin, and two fever hospitals in Cairo. The Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) has helped equip clinical research facilities in the Medical Faculty of Ain Shams University. The site s research work has helped in the drawing up of a national strategy for the control of the epidemic in Egypt. Four of the six members of the National Viral Hepatitis Committee belong to the research network, thus expediting the transfer and use of scientific data in the creation of national policies. Areas of research The site s programs are devoted to basic, clinical and epidemiological research on hepatitis C. The main research objectives are estimation of the prevalence of hepatitis C infection, identification of infection risk factors, optimization of drug regimens in the treatment of acute and chronic hepatitis C, and, with a view on vaccine development, understanding the spontaneous elimination of the virus during the acute phase of the infection.

27 \27 PARTNERS IN EGYPT n Ain Shams University, Faculty of Medicine n Mansoura University n National Hepatology and Tropical Medicine Research Institute (NHTMRI) PARTNERS IN FRANCE n Institut national de la santé et de la recherche médicale (Inserm) n Institut Pasteur de Paris n Hôpital Beaujon, Clichy n Hôpital Bichat-Claude Bernard, Paris n Hôpital Cochin, Paris n Hôpital Gustave-Dron, Tourcoing n Hôpital du Kremlin-Bicêtre n Hôpital Purpan, Toulouse n Hôpital Tenon, Paris Developed world coordinator Pr ARNAUD FONTANET Institut Pasteur Unité d épidémiologie des maladies émergentes 28, rue du Docteur-Roux Paris France [email protected] Resource-limited settings coordinator Pr GAMAL ESMAT The Ministry of Health and Population National Hepatology and Tropical Medicine Research Institute (NHTMRI) 10 Kasr El Aini street, Cairo, Egypt [email protected] Website:

28 28 / Brazil SITE The Evandro Chagas Institute for Clinical Research (IPEC), Fiocruz, Rio de Janeiro. The site Above, the head office of Fiocruz in Rio de Janeiro. Below, brochure published for the tenth anniversary of the ANRS-Brazil collaboration. In July 2001, the Research Agency ANRS (France Recherche Nord&Sud Sida-HIV Hépatites) and the Brazilian Ministry of Health signed a protocol for collaboration with the aim of setting up a partnership between Brazilian and French teams. There is no physical site in Brazil, but rather a French-Brazilian collaborative program. Brazil is one of the resource-limited countries that has implemented the widest-ranging policy for access to antiretroviral treatments. This policy is based on experience and know-how on the production of generic drugs, and on industrial production capacity, which are the subjects of ongoing research. Areas of research The site s work focuses mainly on prevention and on socioeconomic research on health and access to treatment, with programs on access to antiretrovirals, drug policy and intellectual property, technology transfer, analysis of public policies, and vulnerable populations (transand homosexuals). The site s clinical research has taken shape through the establishment of a clinical trial on the treatment of HIV/tuberculosis co-infection. Work also focuses on viral hepatitis through a program designed to characterize hepatitis viruses circulating in Amazonia and their impact on liver disease.

29 \29 PARTNERS IN BRAZIL n Centro de Referência e Treinamento DST/Aids, São Paulo n Escola Nacional de Saúde Publica Sergo Arouca n Hospital Universitário-HUPES, Salvador n Instituto de Economia, Universidade Federal do Rio de Janeiro (UFRJ) n Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ) n Instituto Oswaldo Cruz/IPEC/Laboratório Virtual de Inovação e Propriedade Intelectual em Saúde, Fiocruz, Rio de Janeiro n Universidade Federal do Ceará PARTNERS IN FRANCE AND OTHER COUNTRIES n Gujarat Institute of Development Research, Ahmedabad, India n Hôpital Saint-Louis, Paris n Institut national de la santé et de la recherche médicale (Inserm) n Institut Pasteur n Institut de recherche pour le développement (IRD) n Jawaharlal Nehru University, New Delhi, India n Tulane University, New Orleans, United States n Université Paris-Nord, centre d économie (CEPN) n Université du Québec à Rimouski (UQAR), Canada Developed world coordinator Dr BERNARD LAROUZÉ UMRS 1136 Faculté de médecine Pierre et Marie Curie pôle Saint-Antoine 27, rue de Chaligny Paris cedex 12 France [email protected] Resource-limited setting coordinator CRISTINA PIMENTA Departamento de DST, AIDS e Hepatites Virais Ministério da Saúde Setor de Administração Federal Sul 2, Lote 5/6, Bloco F, Torre 1 Edifício Premium, Asa Sul, , Brasília/DF Brasil [email protected]

30 30 / Ongoing Projects N ANRS/ Reference ANRS ANRS Project Coordinators Project title Country Édouard TUAILLON Diane VALEA Nicolas NAGOT Diane VALEA HIV INFECTION Basic science and physiopathology Immunological and virological infection factors Immune activation and impact of HSV suppressive therapy on genital and systemic HIV-1 replication (ANRS 1285 trial) Biological mechanisms underlying the impact of HSV suppressive therapy on genital and plasma HIV-1 replication Burkina Faso Burkina Faso ANRS PRIVAR Michèle FEVRIER Anfumbom Jude KFUTWAH Analysis of cell-mediated immune response to measles vaccine in HIV-infected infants in Cameroon Cameroon ANRS Martine PEETERS Eitel MPOUDI-NGOLE Inter-species Transmission Identification and risk assessment of additional SIV transmissions from wild living primate populations to humans and thorough exploration of the HIV-1 reservoir ancestors in the great apes from West Central Africa Cameroon, Gabon, Democratic Republic of Congo ANRS RECAMO ANRS CI Jean-Christophe PLANTIER Anfumbom Jude KFUTWAH Jean-Christophe PLANTIER Sandrine MOUSSA Descriptive Epidemiology Molecular Epidemiology Prevalence and virological characterization of dual HIV-1 M and HIV-1 O Cameroon infections and HIV-1 M+O recombinants forms associated or not to dual infection circulating in Cameroon Molecular epidemiology of HIV-1 group O, and other variants non-m circulating in Central African Republic from 2003 to 2011 Central African Republic ANRS DYTRAVIHT Sylvain GODREUIL Hervé HIEN Tuberculosis-HIV co-infections Impact of HIV Mycobacteruim tuberculosis co-infection on the dynamics of tuberculosis transmission in Burkina Faso Burkina Faso ANRS Daniel SCOTT-ALGARA Mariza MORGADO Characterization of innate immunity and biomarkers in tuberculosis/hiv coinfected patients Brazil ANRS Sylvain GODREUIL Didier LAUREILLARD Effect of Mycobacterium tuberculosis genetics on clinical outcomes of HIV/tuberculosis co-infected adults enrolled in the CAMELIA (ANRS 1295/CIPRA KH001) trial Cambodia ANRS TBMACA Marie-Catherine RECEVEUR Serge DOMOUA Prevalence study of tuberculosis and drug susceptibility among detainees at the MACA prison in Côte d Ivoire, in a high HIV prevalence contex Côte d Ivoire ANRS PROMISE-PEP Philippe VAN DE PERRE Nicolas MEDA Clinical research Clinical trials Prevention of Mother to Child Transmission A randomiszed controlled trial comparing the efficacy of infant peri-exposure prophylaxis with Lopinabvir/Ritonavir versus Lamivudine to prevent HIV-1 transmission by breastfeeding (South Africa, Burkina Faso, Uganda, Zambia) South Africa, Burkina Faso, Uganda, Zambia ANRS TEMPRANO Xavier ANGLARET Serge EHOLIE Care by antiretroviral therapy in adults Randomised trial of Izoniazide chemoprophylaxis against tuberculosis, earlier antiretroviral treatment, or both, in HIV-infected adults with CD4 between 250 and 500/mm 3 Côte d Ivoire ANRS DYNA M-O Jean-Christophe PLANTIER Charles KOUANFACK HIV-1 group O strains molecular diversity and therapeutic management in Cameroon Cameroon

31 more at [ ] \31 N ANRS/ Reference ANRS LADY ANRS FATI ANRS THILAO ANRS MOBIDIP ANRS FIT2 ANRS NAMSAL Project Coordinators Project title Country Eric DELAPORTE Sinata KOULLA SHIRO Christine DANEL Serge EHOLIE Roland LANDMAN Serge EHOLIE Laura CIAFFI Sinata KOULLA SHIRO Françoise BRUN-VEZINET Serge EHOLIE Pierre DE BEAUDRAP Charles KOUANFACK Non inferiority randomized open phase III clinical trial comparing the virological efficacy and safety of three second line antiretroviral regimens during 48 weeks in HIV infected patients in Cameroon and Senegal Fozivudine in Africa Trials Initiative (FATI) - Phase II trial Strengthening of medication compliance and treatment with Darunavir and Raltegravir in adults infected with HIV-1 in virologic failure of second line antiretroviral therapy in Sub-Saharan Africa Evaluation of a maintenance strategy with Protease Inhibitors with or without Lamivudine in virologically controlled HIV patients on second line antiretroviral treatment in Africa (Dakar, Bobo Dioulasso, Yaounde) Tolerance and efficacy of four antiretroviral therapy with Tenofovir-Emtricitabine plus Lopinavir/Ritonavir, or Raltegravir or Elvitegravir-Cobicistat among adults HIV-2 infected patients in West Africa. A multicountry and multicenter, phase IIb randomized controlled trial A phase III randomized, open label trial to evaluate Pending Dolutegravir + Lamuvidine + Abacavir versus Efavirenz +Emtricitabine + Tenofovir as part of two treatment sequences for the initial management of HIV infected adults in resource-limited settings (NAMSAL) Burkina Faso, Cameroon, Senegal Côte d Ivoire Burkina Faso, Côte d Ivoire, Mali, Senegal Burkina Faso, Cameroon, Senegal Burkina Faso, Côte d Ivoire, Guinea, Senegal, Togo Burkina Faso Cameroon ANRS MONOD ANRS REFLATE TB ANRS STATIS ANRS RIFAVIRENZ ANRS REFLATE TB2 Valériane LEROY Marguerite TIMITE Jean-Michel MOLINA Beatriz GRINSZTEJN François-Xavier BLANC Serge DOMOUA Maryline BONNET Daniel ATWINE Nathalie DE CASTRO Beatriz GRINSZTEJN Antiretroviral therapy in children Randomized phase 2b trial for evaluation of simplified "once a day" Burkina Faso, Côte d Ivoire antiretroviral strategy in children infected by HIV and under antiretroviral systematic therapy before one year of age Tuberculosis-HIV co-infections A phase II randomized multicenter trial to compare the efficacy and safety of two Brazil doses of Raltegravir or Efavirenz in combination with Tenofovir and Emtricitabine, in naive HIV-infected patients receiving Rifampin for active tuberculosis Systematic empirical versus test-guided anti-tuberculosis treatment impact in severely immunosuppressed HIV-infected adults initiating antiretroviral therapy with CD4 cell counts < 100/mm 3 Interaction between high dose Rifampicin and Efavirenz in pulmonary tuberculosis and HIV co-infection Phase III open-label non inferiority randomized multicenter trial to assess the non-inferiority of Raltegravir versus Efavirenz, both in combination with Tenofovir and Lamivudine in naive HIV-1 infected patients receiving Rifampin for active tuberculosis Cambodia, Côte d Ivoire, Uganda, Vietnam Uganda Brazil, Côte d Ivoire, Vietnam Opportunistic Infections ANRS FLUCOCRYPTO Olivier BOUCHAUD Théodore NIYONGABO Prospective pilot study evaluating efficiency and tolerance of high-dose Fluconazole associated with Flucytosine as induction therapy for Cryptococcal meningitis associated with HIV in Burundi Burundi, Côte d Ivoire ANRS ACTA Olivier LORTHOLARY Charles KOUANFACK A phase III randomised controlled trial of oral Fluconazole plus Flucytosine versus AmB-based therapy for one or two weeks for initial treatment of HIVassociated cryptococcal meningitis Cameroon, Malawi, Zambia ANRS METABODY ANRS TEMPRANO Résistance Laura CIAFFI Assane DIOUF Christine DANEL Thomas d Aquin TONI Diagnostic and Biological follow-up Assessment of lipodystrophy and metabolic disorders in patients on second line antiretroviral treatment in Africa (Bobo Dioulasso, Dakar, Yaounde) : study associated to clinical trial 2-LADY (ANRS 12169) Impact of the CD4 stage when starting ART on the medium-term viral resistances in adults in Côte d Ivoire Burkina Faso, Cameroon, Senegal Côte d Ivoire

32 32 / Ongoing Projects N ANRS/ Reference Project Coordinators Project title Country ANRS Marie-Laure CHAIX Eugène MESSOU Virological failure and HIV-1 resistance to antiretroviral drugs at 36, 48, 60 and 72 months of treatment: a cohort study in HIV-1 infected adults in Abidjan, Côte d Ivoire Côte d Ivoire ANRS PICAM Eric NERRIENET Vonthanak SAPHONN National evaluation of PI-based 2nd line efficacy in Cambodia Cambodia ANRS VIH-2 Viro Jean-Christophe PLANTIER Thomas d Aquin TONI Molecular diagnosis of HIV-2 and dual HIV infections in western Africa Burkina Faso, Cameroon, Côte d Ivoire, Mali Tuberculosis-HIV co-infections ANRS PAANTHER01 Olivier MARCY Vibol UNG Improving diagnosis of Tuberculosis in HIV infected children in Asia (Cambodia, Vietnam) and in Africa (Burkina Faso, Cameroon) Burkina Faso, Cambodia, Cameroon, Vietnam ANRS PROMISE-TB Edouard TUAILLON Chipepo KANKASA PROMoting Infant health and nutrition in Sub-Saharan Africa - Evaluation of Innovative TuBerculosis diagnostic tests (PROMISE-TB) Zambia Opportunistic infections ANRS EDIRAPHIS Mathieu NACHER Stephen VREDEN Histoplasmosis due to Histoplasma capsulatum var. capsulatum in the Guiana Shield and the French West Indies: evaluating prevalence in HIV-infected patients with a rapid diagnostic test using an ELISA capture method for the detection of histoplasma antigens in blood and urine Suriname ANRS PreCASA Olivier LORTHOLARY DEFO Cryptococcal antigen screening, management and outcome in HIV infected patients initiating antiretroviral therapy with less than 100 CD4 cell count at the day hospital of the Yaounde Central Hospital, Cameroon: a prospective study Cameroon ANRS PRECO-CI (following the cohort ANRS 1220 PRIMO-CI) ANRS PEDIACAM II Charlotte LEWDEN Albert MINGA Albert FAYE Mathurin Cyrille TEJIOKEM Cohorts Care by antiretroviral therapy in adults Research platform «Early identification and treatment of early HIV infection in Côte d Ivoire» Care by antiretroviral therapy in children Outcome at 5 years of early treated HIV infected infants with antiretroviral multitherapy in the Pediacam ANRS project Cameroon Côte d Ivoire Cameroon ANRS MAGGSEN Philippe MSELLATI Haby SY SIGNATE Growing up with HIV in Senegal (Risk factors for nutritional and metabolic disorders in children and adolescents on antiretroviral therapy or not) Senegal Socio-behavioural Sciences and Public Health Public Policy Analysis ANRS Maurice CASSIER Marilena CORDEIRO DIAS VILLELA CORREA The new implications of the production of second-line ARVs in Brazil: Using the flexibilities of patent law and producing certified generic drugs Brazil ANRS EVOLCAM Laurent VIDAL Christopher KUABAN Analysis of the Cameroonian ART program evolutions regarding the new issues of HIV care and HIV-related co-infections in the centre and littoral regions Cameroon ANRS Fred EBOKO Maurice ENGUELEGUELE AIDS and Governance in Africa: understanding and reinforcing the action of country-coordinating mechanisms. A comparative study between Senegal, Côte d Ivoire and Cameroon Cameroon, Côte d Ivoire, Senegal Health Economics ANRS Benjamin CORIAT Lia HASENCLEVER Production and procurement of generic ARVs in the context of the post 2005 TRIPS agenda Brazil, India ANRS Fabienne ORSI Claudia CHAMAS Clinical data, bioequivalence and generic drugs. Analysis from India and Brazil Brazil, India

33 more at [ ] \33 N ANRS/ Reference ANRS LADY-SHS Project Coordinators Project title Country Bruno SPIRE Papa Salif SOW Cost-effectivness analysis of three second-line antiretroviral treatment strategies in Africa: research project associated to the ANRS LADY trial Burkina Faso, Cameroon, Senegal ANRS Arnousse BEAULIERE Yaya COULIBALY Non-antiretroviral drugs for HIV-infected adults: quality of prescriptions, cost and cost-effectivness in Côte d Ivoire Côte d Ivoire ANRS CI Benjamin CORIAT Access to HIV viral load in resource-limited settings: market and procurement policies analysis in three countries Brazil, Cameroon, Senegal ANRS CI David GOEURY Hakima HIMMICH Microcredit and people living with HIV, spatial analysis in five African countries Morocco Prevention General population ANRS ORANGE FARM 2 Bertran AUVERT Dirk TALJAARD Evaluation of the extension at community level of safe male circumcision South Africa ANRS TasP François DABIS Marie-Louise NEWELL A cluster randomised trial comparing the impact of immediate versus WHO recommendations guided ART initiation on HIV incidence in Hlabisa sub-district, KwaZulu-Natal, South Africa South Africa ANRS Bertran AUVERT Adrian PUREN Roll-out of voluntary medical male circumcision in Orange Farm (South Africa): effect on HIV incidence among men South Africa Women, children and mother to child transmission ANRS François FAVIER Abdramane BERTHE Action research for the prevention of the HIV-AIDS in Madagascar, Burkina Faso and Cameroon: study of the impact in population of the FMFP program "sexual risks reduction" in women based on the formation of trainers within a global approach of sexuality in a community health type process Burkina Faso, Cameroon, Madagascar ANRS Marc-Eric GRUENAIS Tinoga Laurent OUEDRAOGO Access to maternal/infantile healthcare and follow up of women infected by the HIV/AIDS in Burkina Faso. A multidisciplinary initiative to reduce the transmission of the virus from mother to child Burkina Faso ANRS Alice DESCLAUX Khoudia SOW Infants protected by antiretroviral treatments. Ethnological and compared analysis (Senegal, Burkina Faso, Laos) Burkina Faso, Laos, Senegal ANRS ANRS CohMSM CI Frédéric LE MARCIS Fernand BATIONO Christian LAURENT Yves YOMB Spatial inequality, mobility and exclusive breastfeeding with prophylaxy experience in Burkina Faso: an anthropological and geographical analysis to better understand the constraints of secure breastfeeding Key populations Prevention of HIV infection in men who have sex with men in Sub-Saharan Africa: a feasibility study of an incident multicentric cohort Burkina Faso Burkina Faso, Cameroon, Côte d Ivoire, Mali, Senegal ANRS HANDIVIH Pierre DE BEAUDRAP Gervais BENINGUISSE Disability and HIV: an appraisal of the vulnerability of disabled people to HIV infection in three main cities of Sub-Saharan Africa Burkina Faso Cameroon ANRS CI Alain GIAMI Sergio CARRARA Health and citizenship among Trans individuals in Brazil: a comparative approach (Pilot study) Brazil Screening ANRS Christine SALOMON Marie-Francke PURUEHNCE Age relationships, gender and social change: the impact on HIV testing and care in Pointe Noire (Republic of Congo) Republic of the Congo Living with the disease ANRS TEMPRANO Social Annabel DESGRÉES DU LOU Raïmi FASSASSI General population Social and behavioural impact of very early anti-retroviral treatment within the TEMPRANO trial, Côte d Ivoire Côte d Ivoire

34 34 / Ongoing Projects N ANRS/ Reference Project Coordinators Project title Country Women, children and mother to child transmission ANRS Fred EBOKO Claude ABE Socio-anthropological study: monitoring of HIV-1 infected infants under early anti-retroviral treatment in Cameroon Cameroon ANRS ADOLIANCE Philippe DELMAS Eliana GALANO Psychosocial factors associated with antiretroviral adherence and living experience of adolescents living with HIV in São Paulo Brazil Brazil Other research areas ANRS Frédéric LE MARCIS Mariatou KONE The Clinical trial as a space of encounter. From scientific logics to individual experiences: construction of participant, biosociality and experience of subjectivation Côte d Ivoire Key population ANRS Pierre-Yves BOELLE André PERISSE Sexual networks in HIV infection among MSM: observation, analysis and comparative modeling in Brazil and France Brazil Co-infection HIV/hepatitis viruses Basic Science and Physiopathology Immunological and Virological infection factors ANRS CI Philippe MOREAU Eduardo DONADI Influence of the expression of the immunoregulatory molecule HLA-G in the infection of hepatitis C virus and co-infection HIV/HCV Brazil Descriptive Epidemiology Clinical Epidemiology ANRS VarBva Karine LACOMBE Raoul MOH Genetic variability of HBV in the context of HIV infection in Africa: the VarBvA study Côte d Ivoire ANRS CI Maud LEMOINE Chau NGUYEN VAN VINH Clinical Research Clinical Epidemiology HIV-Hepatitis C co-infection in Vietnam: feasability study of a Peg- Vietnam Interferon/Ribavirin therapy in HIV-HCV co-infected patients living in Ho Chi Minh City Social-behavioural Sciences and Public Health Prevention Key population ANRS DRIVE-IN Nicolas NAGOT Huong DUONG THI DRIVE project: DRugs and viral Infections in Viet Nam DRIVE-IN: DRIVE Feasibility project, Vietnam Screening ANRS DOD-CI Joseph LARMARANGE Christine DANEL Demand and supply of HIV and viral hepatitis B and C testing in Côte d Ivoire pilot phase Côte d Ivoire ANRS CI ANRS CI François DABIS Maïa BUTSASHVILI Caroline BESSON Hasan Ahmed ABD EL-GHAFFAR Hepatitis viruses infection Descriptive Epidemiology Framing potential research in the area of immunogenetic, viral and behavioral risk factors of clinical course of HCV infection in Georgia Georgia Immunological and Virological infection factors Characterisation of hepatitis related lymphomas in Mansoura region (Egypt) Egypt

35 more at [ ] \35 N ANRS/ Reference ANRS Project Coordinators Project title Country Paul DENY Narcisse KOMAS Molecular Epidemiology Delta and B viral hepatitis in Central Africa Republic Central African Republic ANRS Pierre DUJOLS Yacouba NEBIE Epidemiology of hepatitis B and C virus infections nested in a nation-wide population survey in Burkina Faso Burkina Faso ANRS Arnaud FONTANET Richard NJOUOM Epidemiology of viral hepatitis B, C, and delta in Cameroon: analysis of samples collected during the 2011 demographic health survey Cameroon ANRS COPEHEBO Philippe MSELLATI Boubacar NACRO Clinical Epidemiology Clinical and biological evolution of a cohort of children with a chronic hepatitis B infection in Bobo Dioulasso, Burkina Faso Burkina Faso ANRS Christian TREPO Raymundo PARANA Hepatitis B and D viruses in Brazilian Amazonia: analysis of the specific viral genotypes or mutant viruses whose interactions modulate the severity of liver disease Brazil ANRS ViZIR ANRS TAC ANRS Arnaud FONTANET Gamal ESMAT Karine LACOMBE Alain ATTIA Philippe BONNARD Gamal ESMAT Clinical Research Clinical Trials Efficacy and safety of the combination vitamin D, with Pegylated Interferon Egypt α2b/ribavirin in Egyptian patients with untreated chronic hepatitis C: A phase III randomized open-label clinical trial Feasibility, tolerability and efficacy of a 24-week course of Peg-Interferon free treatment with Sofosbuvir and Ribavirin in HCV-genotype 1 and 4 infected patients in West and Central Africa Diagnostic and Biological follow-up Liver fibrosis evaluation among HCV genotype 4 infected patients in Egypt. Comparison of elastometry, histology and serum markers Cameroon, Côte d Ivoire, Senegal Egypt ANRS Marie-Laure CHAIX Diane VALEA Validation and transfer in Burkina Faso of a real-time PCR technique for the HBV DNA detection/quantification Burkina Faso ANRS Arnaud FONTANET Mohsen GADALLAH Cohorts Prospective, multicentered, open cohort of symptomatic acute hepatitis B and C in Egypt (continuation of project ANRS 12122) Egypt Public Policies Analysis ANRS Arnaud FONTANET Wahid DOSS Evaluation of the national treatment program of hepatitis C in Egypt, using data coming from two treatment centres Egypt Prevention Women, children and mother to child transmission ANRS Françoise LUNEL-FABIANI Richard NJOUOM Evaluation of the effectiveness of hepatitis B vaccination of newborns from HBsAg HBe Ag-positive mothers followed by the national enlarged vaccination program including HB in the district health of Tokomberes, Cameroon Cameroon Socio-behavioural Sciences and Public Health Prevention General population ANRS Tamara GILES-VERNICK TRAORE A socio-cultural analysis of hepatitis B disease and vaccination for HVB in two different contexts: Burkina Faso and Central African Republic Burkina Faso Central African Republic

36 more at [ ] Photographs: Dora Bazin - page 2. Brigitte Bazin - pages 4, 5, 7, 8, 9 (top), 16 (bottom), 18 (middle and bottom), 20 (bottom), 21. Geraldine Colin - page 18 (top). Celine Lallemand - page 22 (top and middle) and 24 (top and middle). Claire Rekacewicz - page 26 (top). Laurence Quinty - cover and pages 6, 14, 16 (top and middle), 20, 26, 28. Michel Hasson - pages 17, 19. IRD: Cheik Sokhna, Cécile Neel - page 8. Justine Montmarche - page 10. Luce Arnaud - page 15. Stéphanie Carrière page 23. Monteroi - page 25. Corinne Schwartz - page 27. Pierre Gazin - page 29. Graphic design: Isabelle Benoit. Document designed and produced Research in Resource-limited Settings Department and Scientific Information and Communication Department of the ANRS. 101, rue de Tolbiac Paris Mars 2014