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In a previous article [1], we expressed concern about methods of conduction of the most important studies, related to the most significant publications about HIV natural history and its management, which, since 2008, have been based on studies conducted on a consistent number of patients from all over the world, with the main aim to obtain, in relatively short time, statistical significant data (not always synonymous of statistical clinical meaning). Moreover, these mega-studies (often retrospective analyses, or post-hoc experiences) were signed by hundreds of the so called “collaborators”, all of them “elevated” to the rank of true Authors, through the placement of each single name in all major databases and search engines of the international scientific literature, right since 2008 [1]. In the following years (2009-2010) this phenomenon has, if possible, increased exponentially, leading to a multiplication of these “collaborators”, who, until that date, were just listed in a note in the Acknowledgments section of the article, and were not considered as real authors. The current situation seems to lead to a somewhat unacceptable inflation of the author’s role itself in biomedical publications, based on the well-known statement that should be considered as author one that has given a substantial supply to the design of the study, data results and evaluation, while those who contribute to data collection cannot be included among the Authors. As a specialist in infective diseases, here I would like only to highlight the situation of the most relevant studies in HIV infection, but obviously the same “infection” is contaminating (to use a word common in my field) the whole world of biomedical literature. Even though it is necessary to have wide databases aiming at evaluating the events that happen less frequently, to examine consistent long-term endpoints or pharmacologic safety profiles, nonetheless considerable bias and distortions happen, as a consequence of the extremely high number of the Centres and of the investigators, recruited in a planetary scale [1]. As an example, in Table I are listed the most significant and recent studies (published in 2009-2010) that have also affected the guidelines of the management of HIV-related comorbidities. These studies appear to be burdened by an enormous number of authors and collaborators that clashes especially if compared with the number of patients of cases followed, and with the times of observation and inter-

reviews in health care

Uncontrolled proliferation of the co-authors of clinical and observational studies, and inter-cohort analyses, in the field of clinical management of HIV disease