Quantifying, Explaining and Predicting Survival After Diagnosis of HIV-related Kaposi Sarcoma in East Africa

项目摘要 在撒哈拉以南非洲艾滋病毒感染的恶性并发症中，最常见的癌症之一是 在前抗逆转录病毒治疗（ART）时代-卡波西肉瘤（KS）-仍然是其中之一， 在艺术时代最为常见。尽管ART时代的死亡率有所下降，但KS生存率仍然很低。 然而，在ART时代，KS诊断后的死亡率仍然存在许多问题。 这些问题涉及流行病学和临床管理。还有很多东西要学，作为一个 直接回应对有效策略的迫切需要，以提高艾滋病毒相关患者的生存率， KS，这个指导职业发展建议的总体目标是支持博士。 获得知识和技能，成为临床和翻译领域的独立研究者 艾滋病毒相关癌症研究，重点是努力降低艾滋病毒感染者的KS死亡率 在撒哈拉以南非洲。Byakwaga博士提出了一项与职业有关的研究计划 发展计划，这两个都是由一个多方面的指导团队，将指导她在支持 完成研究并过渡到具有国际竞争力的独立科学家。 具体目标是： 目标1：确定东非感染艾滋病毒的成年人中与KS相关的死亡率过高风险; 目的2：确定HIV感染成人死亡率的潜在生物学决定因素， KS的诊断;以及 目标3：开发并验证HIV相关KS患者死亡率的预测模型 该项目将确定KS对艾滋病毒感染者死亡率影响的真正程度。 个体在ART时代，确定潜在的途径，可以有针对性地减弱KS进展， 并开发一种算法来预测KS诊断后死亡风险最高的人， 干预是最有必要的。总的来说，这项建议描述了一个全面的研究菜单， 和职业发展活动，包括指导和课程，这将有助于博士Byakwaga 实现她的研究目标，成为一名独立的研究人员。

Project Summary Among malignant complications of HIV infection in sub-Saharan Africa, one of the most common cancers in the pre-antiretroviral therapy (ART) era — Kaposi’s sarcoma (KS) — continues to be amongst the most common in the ART era. Despite a decline in mortality in the ART era, KS survival is still unacceptably poor, and many questions remain regarding mortality after KS diagnosis in the ART era. These questions span epidemiology and clinical management. With much yet to be learned, and as a direct response to the urgent need for effective strategies to improve survival of patients with HIV-related KS, the overall goal of this mentored career development proposal is to support Dr. Helen Byakwaga in acquiring the knowledge and skills to become an independent investigator in clinical and translational HIV-associated cancer research, with a focus on efforts to reduce KS mortality among HIV-infected individuals in Sub-Saharan Africa. Dr. Byakwaga has developed a research proposal linked to a career development plan, both of which are supported by a multi-faceted mentoring team that will guide her in completing the research and transitioning to an internationally competitive independent scientist. The specific aims are: Aim 1: Determine excess risk of mortality associated with KS among HIV-infected adults in East Africa; Aim 2: Identify potential biologic determinants of mortality among HIV-infected adults with a new diagnosis of KS; and Aim 3: Develop and validate a prediction model for mortality among individuals with HIV-related KS This project will determine the true magnitude of the impact of KS on mortality among HIV-infected individuals in the ART era, identify potential pathways that can be targeted to attenuate KS progression, and develop an algorithm to predict those at highest risk for death after KS diagnosis and for whom rapid interventions are most warranted. Overall, this proposal describes a comprehensive menu of research and career development activities consisting of mentoring and coursework that will help Dr. Byakwaga to achieve her research objectives and become an independent researcher.