Pediatric HIV and Cancer Epidemiology

儿童艾滋病毒和癌症流行病学

• 批准号: 10427345
• 负责人: Michael E Scheurer
• 金额: $ 17.52万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-25 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10427345
• 关键词: 14 year old; AIDS related cancer; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Acute; Address; Adult; Africa; Africa South of the Sahara; Biological Markers; Blood; Cancer Burden; Caring; Cells; Child; Childhood; Clinic; Clinical; Clinical Data; Collection; Computerized Medical Record; Data; Diagnosis; Disease; Environment; Epidemiology; Future; Goals; HIV; HIV Infections; Human Herpesvirus 4; Human Herpesvirus 8; Immune; Immune system; Incidence; Infection; International; Invaded; Kaposi Sarcoma; Laboratories; Life; Literature; Lymphoma; Malignant Childhood Neoplasm; Malignant Neoplasms; Malnutrition; Medicine; Pediatric Hospitals; Pediatric epidemiology; Plasma; Population; Prevalence; Protocols documentation; Recording of previous events; Research; Resources; Risk; Risk Factors; Screening for cancer; Severities; Site; System; Texas; Time; Update; Ursidae Family; Viral Load result; Viral Markers; Virus; antiretroviral therapy; base; cancer biomarkers; cancer diagnosis; cancer epidemiology; cancer risk; chemokine; clinical risk; cohort; college; comorbidity; cytokine; epidemiology study; experience; high risk; high risk population; infection related cancer; novel; pediatric human immunodeficiency virus; risk prediction

Project 1: Epidemiology of and Risk Prediction for Childhood Cancers in the Context of HIV/AIDS in Africa Sub-Saharan Africa (SSA) disproportionately bears the burden of pediatric HIV/AIDS, having approximately 90% of the 1.7 million pediatric cases of HIV. While substantial progress has been made in recent years to limit the number of new cases of HIV among children, there are still an estimated 1.6 million children living with HIV in SSA. These HIV-infected children are at a higher risk for developing cancer as a result of their disease. The epidemiology of HIV-related malignancies among adults has been fairly extensively studied; however, few epidemiologic studies on cancer among children with HIV have been conducted. Our long-term goal is to determine which HIV-infected children are at highest risk of developing a malignancy. To address these gaps in the epidemiology of pediatric HIV-related malignancies in SSA, we propose the following aims: 1. Calculate the prevalence and incidence of cancers among HIV+ children by expanding and updating a cohort of HIV+ children who are treated and followed at the BIPAI Centers of Excellence. We will leverage both the high-quality electronic medical record system in the BIPAI CoE and affiliated clinic network and the large population of HIV-infected children who have been treated at the CoEs since 2004 to understand the distribution of cancers in this high-risk population. Hypotheses: 1) The incidence of certain infection-related cancers will be higher among HIV-infected children age 14 years or younger, and 2) there will be a lower incidence of HIV-associated cancers (e.g., KS) over the timeframe of this cohort compared to historical data, while the incidence of other non-AIDS defining cancers will be higher. 2. Determine the impact of clinical risk factors on pediatric HIV-related malignancy risk in SSA. We will assess the impact of risk factors such as timing of anti-retroviral treatment, HIV stage at cancer diagnosis, severe acute malnutrition at cancer diagnosis, and geoclimatic differences on HIV-related malignancy risk of children living in SSA. We will also assess whether risk of developing HIV-related malignancies is influenced by history of infections and other co-morbidities. Hypothesis: Factors related to a child's HIV infection severity and early life environment underlie risk of developing pediatric HIV-related malignancies in SSA. 3. Identify plasma biomarkers that are more abundant among HIV+ children diagnosed with cancer. Based on evidence from the literature and our own preliminary data, we will compare a standard set of cytokines/chemokines, and markers of virus burden, in 4 groups of children: 1) HIV+/Cancer+, 2) HIV+/Cancer-, 3) HIV-/Cancer+, and 4) HIV-/Cancer-. The goal is to identify biomarkers of cancer risk in HIV+ children that could be utilized with the clinical factors identified in Aim 2 to develop a novel paradigm for cancer screening in this high-risk population. Hypothesis: There are both specific cancer- and HIV-related differences detectable in the plasma of children who develop HIV-related malignancies compared to those who do not.

项目1：在艾滋病毒/艾滋病的背景下，儿童癌的流行病学和风险预测 非洲 撒哈拉以南非洲（SSA）不成比例地承担小儿艾滋病毒/艾滋病的负担 在170万个小儿艾滋病毒病例中，有90％。近年来已经取得了重大进展 限制儿童中新的艾滋病毒病例的数量，估计有160万儿童 SSA的艾滋病毒。这些感染HIV的儿童由于疾病而患癌症的风险更高。 成年人中与HIV相关的恶性肿瘤的流行病学已经得到了广泛的研究。但是，很少 已经进行了HIV儿童的癌症流行病学研究。我们的长期目标是 确定哪些艾滋病毒感染的儿童患恶性肿瘤的风险最高。解决这些差距 在SSA的儿科HIV相关性恶性肿瘤的流行病学中，我们提出了以下目的： 1。通过扩展和更新来计算艾滋病毒+儿童中癌症的患病率和发病率 在比帕（Bipai）卓越中心接受治疗和遵循的艾滋病毒+儿童队列。 我们将利用Bipai COE的高质量电子病历系统和附属诊所 自2004年以来，网络和大量的艾滋病毒感染儿童接受了COE的治疗 了解在这种高风险人群中癌症的分布。假设：1）某些发病率 在14岁以下的HIV感染儿童中，与感染有关的癌症将更高，2） 在该队列的时间范围内，与HIV相关癌症（例如KS）的发生率较低 历史数据，而定义癌症的其他非AIDS的发病率将更高。 2。确定临床危险因素对SSA中儿科HIV相关的恶性风险的影响。 我们将评估危险因素的影响，例如抗逆转录病毒治疗的时间，癌症的HIV阶段 诊断，癌症诊断时严重的急性营养不良以及HIV相关的地理气候差异 儿童居住在SSA的风险。我们还将评估是否存在与HIV相关的风险 恶性肿瘤受感染史和其他合并症的影响。假设：与 儿童的艾滋病毒感染严重程度和早期生活环境是患儿科HIV相关的风险 SSA的恶性肿瘤。 3。确定在诊断出患有癌症的HIV+儿童中更丰富的血浆生物标志物。 根据文献和我们自己的初步数据的证据，我们将比较一组标准 细胞因子/趋化因子和病毒负担的标志物，4组儿童：1）HIV+/癌症+，2）HIV+/CANCER-， 3）HIV-/CANCAR+和4）HIV-/CANCAR-。目的是确定艾滋病毒+儿童中癌症风险的生物标志物 可以与AIM 2中确定的临床因素一起使用，以开发一种新的范式进行癌症筛查 这个高风险的人口。假设：可检测到的特定癌症和HIV相关差异 与没有艾滋病毒相关的恶性肿瘤的儿童的血浆相比。