Retrovial Infections of the Nervous System in Peru

此RO1应用程序的总体目标是研究临床流行病学和 秘鲁神经系统逆转录病毒感染、机会性感染和热带感染的发病机制 关于R21拨款期间发起的研究合作和调查，题为“中枢神经” 秘鲁的系统感染“；并继续发展神经病学研究人员在学术和 秘鲁全国选定城市的研究机构。这笔赠款的具体目标是1) 明确HTLV-II、HTLV-I、艾滋病毒感染的风险决定因素和临床表现 在秘鲁四个最大的城市，与这三种逆转录病毒病原体中的两种或两种以上合并感染；2) 建立全国HTLV感染临床研究参考中心进行队列研究 中国汉族人HTLV-I和-II感染的自然病史、临床表现及致病机制研究 从血库转介的人；以及3)检查这三种逆转录病毒感染的影响 逆转录病毒感染者中枢神经系统机会性感染和热带感染的自然病史 感染。在我们的R21规划拨款期间，我们发现HTLV-II感染出乎意料地 流行于首都利马和亚马逊地区的两个最大城市的特定人群中 丛林。此外，我们与利马(首都)的神经学家开展了研究合作， 伊基托斯(丛林)、阿雷基帕(安第斯山脉)和特鲁希略(海岸)，并确定了最常见的 神经艾滋病在伊基托斯和阿雷基帕的表现；以及通过会议和国内 培训，为200多名有经验的和新的临床人员提供研究和人体受试者培训 调查人员--其中许多人是神经学家。同时，华盛顿大学领导的艾滋病毒/艾滋病相关研究资金 在秘鲁，来自NIH和私人基金会的资金已经增长到每年500万美元，提供 为进一步发展中枢神经系统逆转录病毒研究计划奠定了坚实的基础。这个 年与研究人员建立的热带神经传染病合作网络 秘鲁的非政府组织和卫生部机构，与美国海军医学研究 在秘鲁的中央支队(NMRCD)，以及秘鲁和美国的大学，将 支持未来关于逆转录病毒感染的临床流行病学及其相互作用的研究 秘鲁并最终在安第斯地区出现新的热带感染。除了继续我们的 调查中，我们计划继续开展培训活动，以解决研究、教育、培训和 在R21规划拨款中确定了与CNS感染相关的指导需求和机会。

The overarching goals of this RO1 application are to study the clinical epidemiology and pathogenesis of retroviral, opportunistic and tropical infections of the nervous system in Peru, building on research collaborations and investigations initiated during the R21 grant entitled "Central Nervous System Infections in Peru"; and to continue development of neurologist investigators in academic and research institutions in selected cities throughout Peru. The specific aims of this grant are to 1) define the risk determinants and clinical manifestations of HTLV-II, HTLV-I, HIV infections and of coinfections with two or more of these three retroviral pathogens in the four largest cities in Peru; 2) establish a national reference center for clinical research on HTLV infection for conduct of cohort studies of the natural history, clinical manifestations, and pathogenesis of HTLV-I and -II infections in persons referred from blood banks; and 3) examine the influence of these three retroviral infections on the natural history of opportunistic and tropical infections of the CNS in persons with retroviral infection. During our R21 planning grant, we discovered that HTLV-II infection was unexpectedly prevalent in selected populations in Lima (the capital) and two of the largest cities in the Amazon Jungle. In addition, we developed research collaborations with neurologists in Lima (the capital), Iquitos (Jungle), Arequipa (Andes Mountains), and Trujillo (Coast), and determined the most common manifestations of neuroAIDS in Iquitos and Arequipa; and through conferences and in-country training, provided research and human subjects training to over 200 experienced and new clinical investigators - many of them neurologists. Concurrently, UW-led HIV/AIDS-related research funding in Peru has grown to $5,000,000 per year from NIH and from private foundations, providing an outstanding foundation for further development of a CNS retroviral research program. The Collaborative Network for Tropical Neurologic Infectious Diseases established with researchers in nongovernmental and Ministry of Health institutions in Peru, with the U.S. Naval Medical Research Center Detachment (NMRCD) in Peru, and with Universities in Peru and the United States, will support future research on the clinical epidemiology of retroviral infections and their interactions with emerging tropical infections in Peru and eventually the Andean Region. In addition to continuing our investigations, we plan to continue training activities to address the research, education, training, and mentoring needs and opportunities related to CNS infection identified during the R21 planning grant.