HIV Co-infections in Uganda: TB, Cryptococcus, and Viral Hepatitis.

乌干达的艾滋病毒合并感染：结核病、隐球菌和病毒性肝炎。

• 批准号: 9257476
• 负责人: Yukari C Manabe
• 金额: $ 28.92万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9257476
• 关键词: Adult; Africa South of the Sahara; Area; Award; Basic Science; Biometry; Caring; Cause of Death; Centers of Research Excellence; Cessation of life; Cirrhosis; Clinical Services; Communicable Diseases; Cryptococcal Meningitis; Cryptococcus; Descriptive Epidemiology; Diagnosis; Doctor of Philosophy; Doctor' s Degree; Epidemic; Evaluation; Funding; Grant; HIV; HIV Infections; Head; Health Sciences; Health system; Hepatitis B; Individual; Infection; Institutes; International; Investigation; Longitudinal cohort; Mentors; Mentorship; Methodology; Modeling; Opportunistic Infections; Patients; Postdoctoral Fellow; Prevalence; Prevention; Primary carcinoma of the liver cells; Public Health Schools; Publishing; Research; Research Institute; Research Personnel; Rotation; Scientist; Students; Training; Training Programs; Tuberculosis; Uganda; Viral; Viral hepatitis; Work; Writing; aged; antiretroviral therapy; co-infection; college; health economics; improved; interest; mortality; novel diagnostics; pathogen; programs; response

DESCRIPTION (provided by applicant): Increasing availability of antiretroviral therapy (ART) in sub-Saharan Africa (SSA) has led to decreases in mortality rates. The WHO estimates that 1.7 million deaths were attributable to HIV in 2011 with the majority caused by co-infecting pathogens. Despite a strong initial response to the HIV epidemic, Uganda still has a prevalence rate of 7.2% among adults aged 15-49 according to UNAIDS. Many patients still present late in infection and often co-infected with opportunistic infections such as tuberculosis (TB) and cryptococcal meningitis. Viral hepatitis (B & C) co-infection occurs in 2-10% of HIV-infected individuals and present challenges in terms of best anti-viral treatment, diagnosis, and prevention. As HIV-infected patients live longer on ART, viral hepatitis related cirrhosis and hepatocellular carcinoma which are accelerated by HIV infection will dominate as causes of death in the virally suppressed. The Infectious Diseases Institute (IDI) in Uganda is a Research Center of Excellence and has already established research programs in HIV co-infections under the previous Head of Research (Y. Manabe, Program Director). The current Head of Research (A. Kambugu, Ugandan Program Director) has worked closely with Dr. Manabe for the last 5 years when he was Head of Clinical Services. Basic descriptive epidemiology has already been published in these focal areas at the IDI by rigorously trained PhD students who have been successfully awarded doctoral degrees and who are capable of original scientific investigation. The overarching objective of the program is to train Ugandans to perform locally relevant research in the area of HIV co-infections including tuberculosis, cryptococcal meningitis, and viral hepatitis. This IDI research context and mentorship model will support post-doctoral researchers at the IDI to become fully independent; capable of writing grants and expanding research interests to prevention, improved models of care, new diagnostics evaluations, advanced biostatistical methodology to analyze longitudinal cohorts, and translational basic science research in Uganda through overseas rotations. Four Masters students will be trained at Johns Hopkins Bloomberg School of Public Health in topical areas for which courses are not available at Makerere College of Health Sciences such as health economics, health systems, and translational, basic research in the co-infections listed above. Three Ugandan Masters' students per year will also be supported to fill the pipeline with new researchers. At the end of this 5-year training program, our overarching objective is to solidify a core group of productive, independent scientists who can garner outside funding, continue to mentor others, and be recognized as international, regional leaders in the area of HIV co-infections.

描述（由申请人提供）：撒哈拉以南非洲（SSA）的抗逆转录病毒疗法（ART）的可用性增加导致死亡率降低。世卫组织估计，2011年有170万人死亡归因于艾滋病毒，大部分是由共同感染的病原体引起的。尽管对艾滋病毒的流行有强烈的初步反应，但根据UNAID的说法，乌干达的患病率仍然为7.2％。许多患者仍在感染后期出现，并经常与机会性感染（例如结核病（TB）和加密局局势炎）共同感染。病毒性肝炎（B＆C）共感染发生在2-10％的HIV感染者中，并就最佳的抗病毒治疗，诊断和预防提出了挑战。随着艾滋病毒感染的患者在ART上的寿命更长，病毒肝炎与HIV感染加速的肝硬化和肝细胞癌相关的肝硬化和肝细胞癌将成为病毒抑制的死亡原因。乌干达的传染病研究所（IDI）是一个卓越研究中心，已经在先前的研究负责人（Y. Manabe，计划主任）下建立了HIV共同感染的研究计划。现任研究负责人（乌干达计划主管A. Kambugu）在过去的5年中与Manabe博士紧密合作，当时他担任临床服务主管。基本的描述性流行病学已经在IDI的这些焦点区域发表，受过严格培训的博士生，他们已成功地授予博士学位，并且能够进行原始的科学研究。该计划的总体目的是训练乌干达人在HIV共同感染领域进行本地相关的研究，包括结核病，隐球菌脑膜炎和病毒肝炎。这种IDI研究环境和指导模型将支持IDI的博士后研究人员完全独立。能够为预防，改进的护理模型，新的诊断评估，先进的生物统计学方法来撰写赠款并扩大研究兴趣，以分析纵向人群的高级生物统计学方法以及乌干达通过海外旋转的转化基础科学研究。四名硕士学生将在局部地区的约翰·霍普金斯彭博公共卫生学院接受培训，在上面列出的共同感染中，在马克雷雷尔卫生科学学院（例如卫生经济学，卫生系统和翻译，基础研究）的课程中，他们的课程无法接受。每年还将支持三名乌干达硕士学生的学生，以填补新研究人员的管道。在这项为期5年的培训计划结束时，我们的总体目标是巩固一个核心的独立科学家群体，他们可以在艾滋病毒共同感染领域获得国际资金，继续指导他人，并被公认为是国际地区领导者。