Table 1 Strengths and weaknesses of the Bissau HIV and the Guinea-Bissau police cohorts and associated research teams
Strengths | Weaknesses |
|---|---|
World’s largest HIV-2 cohort + professional cohort with long and frequent follow-up [4, 12, 98, 130, 131] | High mortality and loss-to-follow-up |
HIV-2 epidemiology well-characterized over three decades [4, 22] | Â |
High patient-turnaround and insufficient staff-resources | |
Strong collaboration with the National Health Laboratory in Guinea-Bissau | Limited lab capacity locally |
Large biorepository with preserved plasma and DNA | Limited sample volume in historical samples |
Cohort clinical real-time database including demographics and follow-up data [24, 133,134,135] | Limited data-entry capacity and political instability [136] |
Close linkage with HIV-cure research environment and in-depth molecular analysis, including access to humanized mice models, ex vivo infection models, full-length genome sequencing and construction of infectious chimeric viruses [35, 98, 137,138,139,140,141] | Weak local research environment with few nationals at Ph.D level |
Well-functioning national ethical committee with enhanced understanding for the complex ethical balancing needed for cure trials | Low health literacy among HIV patients, and extended information and consent procedure needed |
National ethics committee placed within Ministry of Health, and a permission also serves as official government authorization for interventions to be tested | Limited experience among official health authorities for approval of non-approved drugs |
Burden of co-infections and other comorbidities [98, 136, 142,143,144,145,146,147,148,149,150,151] | Limited local diagnostic capacity for a number of co-infections |
Limited local capacity for genotypic resistance, and non-existing for HIV-2 | |
Well-described algorithms for the diagnostic challenges of differentiating HIV-2 and dual-infections [98, 154,155,156,157,158,159,160] | Not the entire cohort tested with updated HIV-2 and HIV-1/HIV-2 dual diagnostics, needs retesting prior to trials |