Dr. Alain Amstutz, MD PhD

Function(s)
Guest Scientist

Organisational Entity

I am a physician researcher with a focus on HIV and NCD care in Southern Africa, mainly Lesotho. I have a particular interest in HIV self-testing, decentralized and differentiated service delivery for HIV and NCDs, management of low-level viremia and clinical trial design.
I have been living in Lesotho for 4 years. During that time, I coordinated four large-scale RCTs. I was responsible for the trial design, protocol writing, field implementation, staff recruitment and training, data collection and basic data analyses, budget administration and stakeholder meetings, as well as result dissemination at local, national and international level.
Until the end of my PhD (08/2021) I had acquired >6.5 Mio CHF research funding (as Principal or Co-Principal Investigator) and published 13 first- and last-author publications in various peer-reviewed journals (Lancet HIV, PLOS Med, CID, JIAS, among others). I fluently speak German, English, French and Italian.
My research projects in Lesotho were part of the International HIV and Chronic Disease Care group, led by Prof. Dr. Niklaus Labhardt, closely developed and implemented in collaboration with all stakeholders of the Swiss-Basotho research consortium: Swiss TPH, Ministry of Health Lesotho, University of Basel and SolidarMed.

The 4 RCTs were:

a) SESOTHO trial: investigating the current HIV viral load threshold used in the WHO guidelines for defining HIV treatment failure (SESOTHO trial main publication; SESOTHO project page)

b) HOSENG trial: evaluating oral HIV self-testing in the community (HOSENG trial; GET ON webpage)

c) VIBRA trial: assessing decentralized community-based antiretroviral treatment initiation and delivery (VIBRA trial; GET ON webpage)

d) PEBRA trial: investigating an innovative model of care for adolescents living with HIV in Lesotho (PEBRA funding / PEBRA protocol / PEBRA webpage / PEBRA project page)

 

Grants / Awards

  • 06/2021 - Grantee of the SSPH+ Award for best published PhD article in public health (CHF 2000): HOSENG trial in the Lancet HIV 2020
  • 12/2020 - Grantee and Co-PI of the TRANSFORM grant (CHF 5,6 Mio), Swiss Agency for Development and Cooperation (SDC/DEZA): Tackling the non-communicable chronic disease epidemic in Southern Africa: A multi-disciplnary initative to validate an eHealth-supported community-based care model delivered by lay health providers (ComBaCaL)
  • 12/2020 - Grantee and Co-PI of the BRCCH-EDCTP Collaboration Initiative 2020 grant (CHF 250'000): Improving access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding and the use of digital solutions in Lesotho and Zambia
  • 11/2020 - Grantee of the Janggen-Pöhn Foundation (40’000 CHF)
  • 09/2019 - Grantee of the alternative HEMMI award (10’000 CHF)
  • 04/2018 - Grantee of the 2018 CIPHER grant by the International AIDS Society (150’000 USD): GET ON IT (GETting tOwards Ninety In Teens) A two-part research project with one cluster-randomized controlled trial assessing targeted interventions to reach the UNAIDS 90-90-90 targets among HIV-positive adolescents and young adults in rural Lesotho, Southern Africa.
  • 07/2017 - Grantee of the 3-year MD-PhD program by SNSF/SAMW (180’000 CHF): Supporting Lesotho on the way towards the UNAIDS 90-90-90 targets: Operational and clinical research addressing HIV/AIDS care in resource-limited settings
  • 07/2017 - Grantee of AlumniMedizin Basel award (20’000 CHF)
  • 05/2017 - Grantee of the Janggen-Pöhn Foundation (39’500 CHF)

Brown J.A, Nsakala B.L, Mokhele K, Rakuoane I, Muhairwe J, Urda L, Amstutz A, Tschumi N, Klimkait T, Labhardt N.D. Viral suppression after transition from nonnucleoside reverse transcriptase inhibitor- to dolutegravir-based antiretroviral therapy: A prospective cohort study in Lesotho (DO-REAL study). HIV Med. 2022;23(3):287-293. DOI: 10.1111/hiv.13189

Amstutz A, Lejone T.I, Khesa L, Kopo M, Kao M, Muhairwe J, Bresser M, Räber F, Klimkait T, Battegay M, Glass T.R, Labhardt N.D. Offering ART refill through community health workers versus clinic-based follow-up after home-based same-day ART initiation in rural Lesotho: the VIBRA cluster-randomized clinical trial. PLoS Med. 2021;18(10):e1003839. DOI: 10.1371/journal.pmed.1003839

Amstutz A, Matsela L, Lejone T.I, Kopo M, Glass T.R, Labhardt N.D. Reaching absent and refusing individuals during home-based HIV testing through self-testing-at what cost?. Front Med. 2021;8:653677. DOI: 10.3389/fmed.2021.653677

Brown J.A, Amstutz A, Nsakala B.L, Seeburg U, Vanobberghen F, Muhairwe J, Klimkait T, Daniel Labhardt N. Extensive drug resistance during low-level HIV viraemia while taking NNRTI-based ART supports lowering the viral load threshold for regimen switch in resource-limited settings: a pre-planned analysis from the SESOTHO trial. J Antimicrob Chemother. 2021;76(5):1294-1298. DOI: 10.1093/jac/dkab025

Lohner S, Gryaznov D, von Niederhausern B, Speich B, Kasenda B, Ojeda-Ruiz E, Schandelmaier S, Mertz D, Odutayo A, Tomonaga Y, Amstutz A, Pauli-Magnus C, Gloy V, Bischoff K, Wollmann K, Rehner L, Meerpohl J.J, Nordmann A, Klatte K, Ghosh N, Heravi A.T, Wong J, Chow N, Hong P.J, Cord K.M, Sricharoenchai S, Busse J.W, Agarwal A, Saccilotto R, Schwenkglenks M, Moffa G, Hemkens L.G, Hopewell S, von Elm E, Blumle A, Briel M. Reporting quality of trial protocols improved for non-regulated interventions but not regulated interventions: a repeated cross-sectional study. J Clin Epidemiol. 2021;139:340-349. DOI: 10.1016/j.jclinepi.2021.05.011

Mapesi H, Gupta R, Wilson H.I, Lukau B, Amstutz A, Lyimo A, Muhairwe J, Senkoro E, Byakuzana T, Mphunyane M, Bresser M, Glass T.R, Lambiris M, Fink G, Gingo W, Battegay M, Paris D.H, Rohacek M, Vanobberghen F, Labhardt N.D, Burkard T, Weisser M. The coArtHA trial—identifying the most effective treatment strategies to control arterial hypertension in sub-Saharan Africa: study protocol for a randomized controlled trial. Trials. 2021;22:77. DOI: 10.1186/s13063-021-05023-z

Amstutz A, Brown J.A, Ringera I, Muhairwe J, Lejone T.I, Klimkait T, Glass T.R, Labhardt N.D. Engagement in care, viral suppression, drug resistance and reasons for non-engagement after home-based same-day ART initiation in Lesotho: a two-year follow-up of the CASCADE trial. Clin Infect Dis. 2020;71(10):2608-2614. DOI: 10.1093/cid/ciz1126

Amstutz A, Kopo M, Lejone T.I, Khesa L, Kao M, Muhairwe J, Glass T.R, Labhardt N.D. "If it is left, it becomes easy for me to get tested": use of oral self-tests and community health workers to maximize the potential of home-based HIV testing among adolescents in Lesotho. J Int AIDS Soc. 2020;23(Suppl. 5):e25563. DOI: 10.1002/jia2.25563

Amstutz A, Lejone T.I, Khesa L, Muhairwe J, Bresser M, Vanobberghen F, Kopo M, Kao M, Nsakala B.L, Tlali K, Klimkait T, Battegay M, Labhardt N.D, Glass T.R. Home-based oral self-testing for absent and declining individuals during a door-to-door HIV testing campaign in rural Lesotho (HOSENG): a cluster-randomised trial. Lancet HIV. 2020;7(11):e752-e761. DOI: 10.1016/S2352-3018(20)30233-2

Amstutz A, Nsakala B.L, Cheleboi M, Lejone T.I, Hobbins M.A, Battegay M, Klimkait T, Labhardt N.D. Low rates of active hepatitis B and C infections among adults and children living with HIV and taking antiretroviral therapy: a multicenter screening study in Lesotho. J Med Virol. 2020;92:3857–3861. DOI: 10.1002/jmv.25970

Amstutz A, Nsakala B.L, Vanobberghen F, Muhairwe J, Glass T.R, Namane T, Mpholo T, Battegay M, Klimkait T, Labhardt N.D. Switch to second-line versus continued first-line antiretroviral therapy for patients with low-level HIV-1 viremia: an open-label randomized controlled trial in Lesotho. PLoS Med. 2020;17(9):e1003325. DOI: 10.1371/journal.pmed.1003325

Brown J.A, Ringera I, Luoga E, Cheleboi M, Kimera N, Muhairwe J, Kayembe B.P, Molapo Hlasoa M, Kabundi L, Yav C.W.D, Mothobi B, Thahane L, Amstutz A, Bachmann N, Mollel G.J, Bresser M, Glass T.R, Paris D.H, Klimkait T, Weisser M, Labhardt N.D. Genotype-Informed Versus Empiric Management Of VirEmia (GIVE MOVE): study protocol of an open-label randomised clinical trial in children and adolescents living with HIV in Lesotho and Tanzania. BMC Infect Dis. 2020;20:773. DOI: 10.1186/s12879-020-05491-9

Gryaznov D, Odutayo A, von Niederhausern B, Speich B, Kasenda B, Ojeda-Ruiz E, Blumle A, Schandelmaier S, Mertz D, Tomonaga Y, Amstutz A, Pauli-Magnus C, Gloy V, Bischoff K, Wollmann K, Rehner L, Lohner S, Meerpohl J.J, Nordmann A, Klatte K, Ghosh N, Heravi A.T, Wong J, Chow N, Hong P.J, Cord K.M, Sricharoenchai S, Busse J.W, Agarwal A, Saccilotto R, Schwenkglenks M, Moffa G, Hemkens L.G, Hopewell S, von Elm E, Briel M. Rationale and design of repeated cross-sectional studies to evaluate the reporting quality of trial protocols: the Adherence to SPIrit REcommendations (ASPIRE) study and associated projects. Trials. 2020;21:896. DOI: 10.1186/s13063-020-04808-y

Lejone T.I, Kopo M, Bachmann N, Brown J.A, Glass T.R, Muhairwe J, Matsela T, Scherrer R, Chere L, Namane T, Labhardt N.D, Amstutz A. PEBRA trial - effect of a peer-educator coordinated preference-based ART service delivery model on viral suppression among adolescents and young adults living with HIV: protocol of a cluster-randomized clinical trial in rural Lesotho. BMC Public Health. 2020;20(1):425. DOI: 10.1186/s12889-020-08535-6

Amstutz A, Lejone T.I, Khesa L, Muhairwe J, Nsakala B.L, Tlali K, Bresser M, Tediosi F, Kopo M, Kao M, Klimkait T, Battegay M, Glass T.R, Labhardt N.D. VIBRA trial - effect of village-based refill of ART following home-based same-day ART initiation vs clinic-based ART refill on viral suppression among individuals living with HIV: protocol of a cluster-randomized clinical trial in rural Lesotho. Trials. 2019;20:522. DOI: 10.1186/s13063-019-3510-5

Amstutz A, Lejone T.I, Khesa L, Muhairwe J, Nsakala B.L, Tlali K, Bresser M, Vanobberghen F, Kopo M, Kao M, Klimkait T, Battegay M, Labhardt N.D, Glass T.R. The HOSENG trial - effect of the provision of oral self-testing for absent and refusing individuals during a door-to-door HIV-testing campaign on testing coverage: protocol of a cluster-randomized clinical trial in rural Lesotho. Trials. 2019;20:496. DOI: 10.1186/s13063-019-3469-2

Glass T.R, Motaboli L, Nsakala B, Lerotholi M, Vanobberghen F, Amstutz A, Lejone T.I, Muhairwe J, Klimkait T, Labhardt N.D. The viral load monitoring cascade in a resource-limited setting: a prospective multicentre cohort study after introduction of routine viral load monitoring in rural Lesotho. PLoS One. 2019;14(8):e0220337. DOI: 10.1371/journal.pone.0220337

Labhardt N.D, Ringera I, Lejone T.I, Amstutz A, Klimkait T, Muhairwe J, Glass T.R. Effect and cost of two successive home visits to increase HIV testing coverage: a prospective study in Lesotho, Southern Africa. BMC Public Health. 2019;19:1441. DOI: 10.1186/s12889-019-7784-z

Speich B, Schur N, Gryaznov D, von Niederhäusern B, Hemkens L.G, Schandelmaier S, Amstutz A, Kasenda B, Pauli-Magnus C, Ojeda-Ruiz E, Tomonaga Y, McCord K, Nordmann A, von Elm E, Briel M, Schwenkglenks M, MARTA and ASPIRE Study Groups. Resource use, costs, and approval times for planning and preparing a randomized clinical trial before and after the implementation of the new Swiss human research legislation. PLoS One. 2019;14(1):e0210669. DOI: 10.1371/journal.pone.0210669

Amstutz A, Nsakala B.L, Vanobberghen F, Muhairwe J, Glass T.R, Achieng B, Sepeka M, Tlali K, Sao L, Thin K, Klimkait T, Battegay M, Labhardt N.D. SESOTHO trial ("Switch Either near Suppression Or THOusand") - switch to second-line versus WHO-guided standard of care for unsuppressed patients on first-line ART with viremia below 1000 copies/mL: protocol of a multicenter, parallel-group, open-label, r. BMC Infect Dis. 2018;18:76. DOI: 10.1186/s12879-018-2979-y

Labhardt N.D, Ringera I, Lejone T.I, Klimkait T, Muhairwe J, Amstutz A, Glass T.R. Effect of offering same-day ART vs usual health facility referral during home-based HIV testing on linkage to care and viral suppression among adults with HIV in Lesotho: the CASCADE randomized clinical trial. JAMA. 2018;319(11):1103-1112. DOI: 10.1001/jama.2018.1818