Pre Malignant Cirrhosis and Hepatocellular Carcinoma in HIV Infected Ugandans

感染艾滋病毒的乌干达人发生恶性前肝硬化和肝细胞癌

• 批准号: 8934567
• 负责人: Gregory D Kirk
• 金额: $ 22.28万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8934567
• 关键词: Address; Adherence; Aflatoxins; Africa; Africa South of the Sahara; African; Age; Alcohol consumption; Alcohols; Award; Biological Markers; CD4 Positive T Lymphocytes; Case-Control Studies; Cause of Death; Cervix carcinoma; Chronic; Chronic Hepatitis B; Cirrhosis; Clinic; Clinical; Clinical Research; Collaborations; Communicable Diseases; DNA; Data; Detection; Developed Countries; Development; Diagnosis; Disease; Early Diagnosis; Early treatment; Environment; Epidemiology; Etiology; Exposure to; Fibrosis; Foundations; Future; Gender; Goals; Grant; HIV; HIV Infections; Hepatitis B; Hepatitis B Virus; Hepatitis C virus; Herbal Medicine; Immunosuppression; Incidence; Infection; Injection of therapeutic agent; Institutes; Intervention; Intervention Trial; Investigation; Kaposi Sarcoma; Laboratories; Laboratory Research; Lamivudine; Lesion; Life; Liver Cirrhosis; Liver Fibrosis; Liver diseases; Lymphoma; Malignant Neoplasms; Measures; Medical; Mentors; Methods; Obesity; Pathogenesis; Patients; Pattern; Persons; Pilot Projects; Plasma; Population; Population Research; Premalignant; Prevalence; Prevention strategy; Primary carcinoma of the liver cells; Publications; Radiofrequency Interstitial Ablation; Research; Research Infrastructure; Research Personnel; Research Project Grants; Resources; Risk; Risk Management; Role; Satellite Viruses; Schistosomiasis; Screening for cancer; Staging; Target Populations; Tenofovir; Time; Translational Research; Uganda; Ultrasonography; Universities; Viral; Viral hepatitis; Work; antiretroviral therapy; base; career development; cohort; combat; elastography; emtricitabine; high risk; improved; insight; multidisciplinary; novel; programs; screening; success; transmission process; treatment strategy

Proposed is a collaborative partnership between Makerere University and Johns Hopkins on HIV and hepatocellular carcinoma (HCC) in Uganda: The H2U Consortium. Hepatocellular carcinoma (HCC) is a very common and lethal cancer in Africa, and as patients with HIV live longer, the HCC burden will increase. The overarching goal of the Consortium is to reduce the heavy burden of HIV-associated HCC in sub-Saharan Africa. Building on long-standing collaborations, the Consortium expands will answer unresolved, high priority questions on the fundamental epidemiology and etiology of HIV-associated HCC, while expanding the clinical and laboratory research capacity in Uganda to address these issues. The Specific Aims include: 1) To enhance Ugandan investigator capacity for conducting high-level, collaborative, multidisciplinary scientific investigation of HIV-associated HCC; 2) To solidify the clinical, population and translational research infrastructure; 3) To advance the foundational understanding of the epidemiology, mechanisms, and clinical spectrum of HIV-associated HCC; and 4)To inform prevention and treatment strategies applicable to HIV-associated HCC in resource-limited settings. We propose two major clinical projects, including a large case-control study of 600 HCC cases and 600 controls to define the role of HIV and related immunosuppression. We also will screen 3000 HIV-infected clinic patients for pre-malignant liver cirrhosis and for high-risk hepatitis B and aflatoxin-related biomarkers, then follow this high-risk group with regular HCC screening to determine feasibility and whether early stage HCC can be identified. Our Developmental Core will implement the H2U Scholars Award, pairing a Ugandan investigator with a senior Hopkins mentor and supporting career development and a collaborative pilot project. The proposed studies will enhance our clinical and mechanistic understanding of HIV-associated HCC, provide evidence on appropriate treatment, and inform intervention strategies to combat HIV and HCC in Africa. The impact of our integrated research and capacity development activities will be establishment of the H2U Consortium as a Center of Excellence on HIV and HCC in Africa.

提议的是马凯雷雷大学和约翰霍普金斯大学在乌干达艾滋病毒和肝细胞癌（HCC）方面的合作伙伴关系：H2 U联盟。肝细胞癌（HCC）在非洲是一种非常常见和致命的癌症，随着HIV患者的寿命延长，HCC的负担将增加。联合会的首要目标是减轻撒哈拉以南非洲地区艾滋病毒相关HCC的沉重负担。在长期合作的基础上，该联盟扩大了对艾滋病毒相关肝细胞癌基本流行病学和病因学方面尚未解决的高度优先问题的研究，同时扩大了乌干达的临床和实验室研究能力，以解决这些问题。具体目标包括：1）提高乌干达研究人员对艾滋病毒相关性肝癌进行高水平、协作性、多学科科学研究的能力; 2）巩固临床、人口和转化研究基础设施; 3）推进对艾滋病毒相关性肝癌的流行病学、机制和临床谱的基本理解;和4）为资源有限环境中适用于HIV相关HCC的预防和治疗策略提供信息。我们提出了两个主要的临床项目，包括一个大型的病例对照研究600例肝癌病例和600例对照，以确定艾滋病毒和相关的免疫抑制的作用。我们还将对3000名HIV感染的门诊患者进行癌前肝硬化、高危B型肝炎和黄曲霉毒素相关生物标志物的筛查，然后对这一高危人群进行定期HCC筛查，以确定是否可以识别早期HCC。我们的发展核心将实施H2 U学者奖，将乌干达研究员与高级霍普金斯导师配对，并支持职业发展和合作试点项目。拟议的研究将提高我们对HIV相关HCC的临床和机制的理解，提供适当治疗的证据，并为非洲防治HIV和HCC的干预策略提供信息。我们的综合研究和能力发展活动的影响将是建立H2 U联盟作为卓越中心 艾滋病毒和HCC在非洲。