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REACH: Russian European Alliance for research among women, Children and adolescents impacted by HIV, TB and HCV

Periodic Reporting for period 2 - REACH (REACH: Russian European Alliance for research among women, Children and adolescents impacted by HIV, TB and HCV)

Reporting period: 2020-01-01 to 2020-12-31

Pregnant women, children and adolescents are priority populations in the global public health response to the epidemics of HIV, TB and HCV. The high burden of intersecting epidemics of these 3 infections pose a major public health challenge to Russia and the broader European region. The global health goals of ending AIDS, reducing TB deaths and new HCV cases by 90% by 2030 can only be realized if the unique health needs are considered and targeted research to these priority populations is undertaken to optimize the impact of innovations in diagnostics and treatment. REACH builds on a long-standing, successful collaboration between European clinical research networks with track records of delivering innovative research across the three infections with leading collaborators from 3 centres of excellence in Siberian, North-western and Central districts of the Russian Federation.
The main objective of the project is to contribute to the progress towards an AIDS-free generation through the following tasks:
1.Conduct joint research to better understand the epidemiology, disease progression, treatment and outcomes of HIV, TB and HCV mono- and co-infections among pregnant women, children and adolescents with the long-term goal of reducing morbidity and mortality among these vulnerable groups
2.Exchange of knowledge between Russian and European specialists, capacity building and preparation for future collaborative research on HIV, HCV and TB in children and adolescents.

REACH will explore utilisation of new diagnostics and preventive TB treatment and the use of novel direct acting antivirals for HCV in children in real-world setting. REACH will promote geographic expansion of the collaborative research in maternal and child health in Europe with a broad and long-lasting impact.
It will also build capacity for improved coordination and integration between European and Russian research centres beyond 2020.
-During the second year of the project two online General Assembly meetings took place, on 2nd June and 10th November 2020. During these calls all WP and Task Leaders presented the results of their work and how they foresee completing the tasks by the end of the Project.
-Regular teleconferences with each working group, including European and Russian partners were conducted to ensure the project is on track and any delays with the completion of the tasks and deliverables are addressed.
-The Paediatrics Working group established in year one continued to meet regularly to provide overall guidance on their activities.
-Following discussions with REACH partners in response to an opportunity to harmonise data collection with a Europe-wide collaborative study, the European Pregnancy & Paediatric Infections Cohort Collaboration (EPPICC) study protocol and Standard Operating Procedures (SOP) in 2020 were developed to maximize the potential outputs of this study.
-All partners agreed it was important to incorporate collection of data on the diagnosis, treatment and outcome of COVID-19 in children and adolescents living with HIV.
-Ethics approval from the UCL Research Ethics Committee (REC) was received in December 2020.
-A number of statistical analyses were conducted using the 2016 paediatric data merger. This resulted in three conference abstracts being submitted, of which two were selected and presented as poster presentations
i. Cascade of care in children and adolescents with HIV in Russian Federation by A. Turkova, E Voronin, Y Plotnikova et al. International Workshop on HIV Pediatrics 2020. 16-17 November 2020. Poster#68.
ii. Characteristics and cascade of HIV care in children with perinatally acquired HIV in three Russian clinics by L. Okhonskaia, E Voronin, Y Plotnikova et al. 38th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID), 26-29 October 2020. Poster#740.
-Specific analysis were conducted using the 2016 pregnancy data merger, the results were presented as a poster presentation as part of a poster walk at the 10th International Workshop on HIV and Women (Boston, US, early March 2020).
-A working group was established to harmonise approaches to data analyses, focusing on the cascade of care of children and adolescents living with HIV in Russia.
-An online training course took place on Tuesday 23rd June–Tuesday 25th August 2020 with approx. 500 delegates from across Russia and 14 faculty members from Russia, Europe. The course focussed on epidemiology of HIV and the direct and indirect impact of COVID-19, use of ART, PMTCT, resistance and second line therapy, TB and HIV, HCV, adolescents and HIV, research updates and methodology.
-Colleagues from the TB Dispensary and The Northern State Medical University in Arkhangelsk (NSMU) visited the Basel University Children’s Hospital and the Mycobacterial Research Laboratory in Basel (Switzerland) for on-site training from 16 -19 February 2020. The visit focussed on knowledge transfer and exchange with the Russian team to be able to establish a laboratory-based research study in Arkhangelsk, Russian Federation.
-An anonymised survey of paediatric HCV care policies and practices was developed. The survey covers clinical and therapeutic management of children with chronic HCV monoinfection and HIV/HCV co-infection and, including approaches to staging liver disease and other monitoring strategies.
-Young people involved in the REACH project as part of the Youth Advisory Board met online to work on a style guide for the resources the group will produce.
Our priorities have evolved from the findings of ongoing successful collaborations with partners across the Russian Federation and our focus echoes the priority of maternal and child health within the public health service in Russia. Our work will help inform important research gaps regarding risk of onward transmission, disease progression, ART toxicity, drug resistance, comorbidities and coinfections, and contribute to capacity building in key areas to advance future research, treatment and prevention of HIV, HCV and TB.
Improved evidence base on diagnostics, risk factors and clinical outcomes in pregnant women and children in the context of the ongoing epidemics of HIV, HCV and TB in Russia will help to identify potential interventions to reduce the morbidity and mortality associated with these infections over the long term.
Multi-modal Russian language clinical and research training materials will be developed by international teams to provide up to date information on diagnosis and treatment to health care professionals caring for pregnant women and children infected with HIV, HCV and TB.
The knowledge sharing, training and capacity building work in the REACH Forward work package will significantly improve the skill set of European and Russian clinical and research investigators to effectively prevent, diagnose, treat and care for pregnant women and children living with HIV, TB and HCV.
The REACH project will improve coordination and integration of existing Russian/EU collaborations and create new international relationships to advance research opportunities. The results of the proposed work will build foundation for further diagnostic studies on TB biomarkers and advanced imaging for early recognition of atherosclerosis and neurological impairment in HIV-infected youth and development of a clinical trial in novel treatment for HCV in children.
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