Multicentre inter-cohort studies - reliable responses for HIV disease management?

The most recent evidences on HIV infection were obtained through large multicentre trials/inter-cohort analyses including patients enrolled by hundreds of investigators and co-investigators around the world. While extensively pooled data are needed to assess infrequent events (rare toxicities), long-term endpoints, or safety (e.g. mortality or lipodystrophy syndrome), or to perform comparative studies between different treatments, relevant biases/distortions descending from the extremely elevated number of enrolling centers/investigators are expected, while the reports among quoted co-authors of all investigators/co-investigators supports an unacceptable number of presumptive authors. As is known, a relevant number of outstanding multicentre/inter-cohort studies signed by thousands of co-authors, comprehensively quoted in all bibliographic databases, have been published in the last months by leading medical journals (starting just from 2008), especially in the attempt to focus on some infrequent HIV disease complications, and regarding efficacy and tolerability of novel antiretroviral therapies (ART). Some representative studies are summarized in the table.