Project supported by The EEA Financial Mechanism & The Norvegian Financial Mechanism (2009-2011):

Monitoring of HIV pandemic in Hungary by molecular virological methods

 

Applicant (project owner)

Name: National Centre for Epidemiology
Country: Hungary
Address: H-1097 Budapest, Gyáli út 2-6
Phone:+36-1-476-1194
Type: governmental organization
Tax number: 16606337-2-43
Internet: www.oek.hu

Contact person

Name: Dr János Minárovits
National Centre for Epidemiology, Microbiological Research Group 
(NCE -MRG)
Address: H-1529 Budapest, Pihenő út 1
Phone: +36-1-394-5044
Fax: +36-1-394-5409
E-mail: minimicrobi@hotmail.com

 

Summary

Human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), spread all over the world causing a pandemic. The virus replicates in the cells of the immune system and damages their function. The collapse of the immune system results in the development of opportunistic infections and malignant tumours (AIDS). The HIV epidemic expanded slowly in Hungary, due to the proper public health measures introduced to curb it (establishment of screening and confirmatory laboratories, testing of blood products). The number of HIV infected individuals is comparatively low: there were 1485 registered HIV infected individuals in Hungary till December 31, 2007 (Epinfo Vol. 15, No. 7, 2008), in a population of 10 million.

The National Centre for Epidemiology (NCE) plays a basic role in preventing the spread of the HIV epidemic in Hungary, and - as a board member of the European Centre for Disease Prevention and Control (ECDC) - NCE is committed to maintain a high level of competence in epidemiology. Because HIV is one of the most important topics for ECDC, the activities of NCE and its Microbiological Research Group (NCE-MRG) fit well to the public health strategy of ECDC, and, accordingly, it contains international elements, reaching over borders, too. In addition, the implementation of our project will be supervised by Dr Birgitta sjö and her colleagues (Bergen, Norway), based on a bilateral agreement of our laboratories. Dr sjö is an outstanding HIV expert who did very important observations related to the cellular tropism of HIV strains. Her expertise guarantees a high level realization of our project.

Most of the HIV infections in Hungary were confirmed by the co-workers of NCE-MRG, in the special laboratory of the Research Group. The major motivation of our project proposal is that new activities and actions became necessary to maintain the favourable epidemiological status in Hungary. These new actions are in harmony with the current international recommendations and consist of two parts: 

  1. continuous monitoring of the epidemic caused by highly variable HIV strains using molecular virological methods (HIV subtype determination using genomic sequencing)
  2. detecting the especially dangerous drug-resistant HIV strains in newly infected individuals (as suggested by the European HIV Drug Resistance Panel).

The conditions necessary for the implementation of the project (laboratory conditions, equipments, personnel) are guaranteed in the National HIV Reference Laboratory working in the framework of NCE-MRG. The NCE-MRG is the only accredited HIV confirmatory laboratory in Hungary (Registration No.: NAT-1-1474/2006).

As a result of our project we could continuously monitor, using up-to-date molecular methods, the spread of HIV pandemic in Hungary, with special regard to the drug-resistant HIV strains; in addition an effective initial antiretroviral therapy would also be possible.

We wish to enlarge the range of accredited tests of the National HIV Reference Laboratory by introducing a new molecular diagnostic test, the determination of HIV drug resistance based on genomic sequencing. Due to the project, the diagnostic repertoire of the National HIV Reference Laboratory would be extended by another molecular test as well (HIV subtype determination by genotyping). Unfortunately there is no external proficiency programme available for HIV genotyping yet, therefore accrediting of this test can be done only at a later time point.

Setting up the method of HIV drug-resistance detection and the analyses related to this test are important steps in the preparation of the accreditation of this methodology. Harmonizing the methods, building them into a unified system, and scaling up the quality control system needs significant initial costs. Thereafter, however, maintaining the diagnostic system is possible based on a much lower calculated cost, that is at the disposal of NCE. Thus, from the economic point of view, a maintainable development can be assured.

We are confident, that the methodological repertoire of NCE-MRG, extended with two new molecular virological tests, will permit, in harmony with international recommendations, a detailed immunological and genetic characterization of  HIV strains from newly infected individuals in Hungary

The NCE-MRG ensures during its operation equal rights (as it will be described in the relevant directive) and open access. We prepared a separate dissemination plan related to the project. We put a great emphasis on maintainable development not only from the economic point of view, as outlined above, but also related to ecological and social aspects, and these aspects will be apparent in our communications, too.

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