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Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH   Imprimer la page  
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About the database
Déjà 20 ans !
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- RICE février 2013
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The French Hospital Database on HIV is a hospital multicentre open cohort with on-going inclusion since 1989. Patients are eligible if they are infected by HIV-1 or HIV-2; are managed in a participating centre (69 hospitals and/or wards in 2010) and give their written informed consent. The project was approved by the French computer watchdog (CNIL) on 27 November 1991 (Journal Officiel, 17 January 1992). Because of the need to return to the patient medical records to validate data for specific research projects, CNIL approval for a local correspondence list was obtained in 1999. The database includes data from 69 hospitals or wards distributed among 26 of the 28 COREVIH (Coordination régionale de la lute contre le VIH). The database included data on over 122,000 patients aged at least 15 years and seen at least once between 1 January 1992 and 31 December 2010 with a mean follow-up of 85 months. The research projects are mainly focused around the biggest advantage of the database, its size, paying attention not to overcome other ANRS cohort main themes. They are:
• Therapeutics strategies: mid and long term clinical outcomes
o Including comparative effectiveness techniques such as causal models
• Severe AIDS and non AIDS morbidity/mortality: role of HIV infection and of exposure to antiretroviral treatments
o Including malignancies and cardiovascular diseases
• Surveillance of HIV infection in France
• Open theme
o Any participating centre can submit a project to the scientific committee
o Any researcher can submit a project to the scientific committee
In addition, 2 strategic groups have been created to develop specific projects on migrants on the one hand and on HCV coinfection on the other hand. A scientific committee with a maximum of 40 members, regularly renewed, debates FHDH research themes and selects projects according to their feasibility and scientific pertinence. Data are collected from medical records. Many validation procedures before inclusion of the data into the database and local audits are performed to ensure good quality data.
The French Hospital Database is part of numerous collaborations, including ART-CC (Antiretroviral Cohort Collaboration, since its creation in 2000), EUROCOORD (NOE FP7 2011-2015, including CASCADE, since 2006 and COHERE since its creation) and HIV-Causal (headed by M Hernán, Harvard School of Public Health). Besides research projects, the database allows to describe the epidemiology of HIV infection in patients in hospital care in France knowing that in France ARV treatments are initiated or changed only in hospital. The completeness of the database is around 57% and the database is representative of those in care in France. The database is used to evaluate the public health impact of antiretroviral drugs, with 8 contracts involving 3 partners (INSERM, INSERM Transfert, pharmaceutical company) on going or completed. As antiretroviral drugs (62%) and hospitalization (31%) accounts for 93% of care costs for HIV-infected individuals, available data allow estimating most of the care costs for these patients.
Since 1992, 121 publications based on the FHDH data have been published in peer-reviewed journals.

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