HIV CO-INFECTIONS IN UGANDA

撒哈拉以南非洲(SSA)抗逆转录病毒疗法(ART)的可获得性增加，导致 死亡率的下降。世界卫生组织估计，9400亿人的死亡是由于 2017年感染艾滋病毒，其中大部分是由合并感染病原体引起的。 乌干达15-49岁成年人的患病率仍为6.5%(联合国艾滋病规划署)。很多病人 仍在晚期，且经常与结核病(TB)等机会性感染合并感染 和隐球菌性脑膜炎。乙型和丙型肝炎合并感染的比例为2%-10% 在最佳抗病毒治疗、诊断和预防方面的挑战。挑战摆在眼前 对接受抗逆转录病毒治疗的艾滋病毒感染者也是如此，因为他们患“非艾滋病”的风险更高。 非传染性疾病，特别是高血压、糖尿病、肾病、 肺部疾病、心血管疾病、癌症、骨骼异常和肝功能衰竭。艾滋病病毒 感染本身似乎也与加速衰老过程有关。 乌干达传染病研究所(IDI)是 卓越，并已在艾滋病毒和混合感染方面建立了研究计划 前研究负责人(Y.Manabe和前项目主任A Kambugu 和乌干达方案主任)。现任研究主管(B Castelnuovo- 本周期中的拟议计划主任)，曾与马纳贝博士和 Kambugu在过去的10年里，当时她是研究能力建设的负责人 单位和研究部副主任。 我们计划在Makerere培养9名硕士、2名博士生和5名博士后 乌干达，大学。我们之前的5年周期巩固了一批富有成效的、 通过博士后培训的独立科学家，他们现在可以充当当地的导师。我们 将培训项目的领导权从美国转移到乌干达机构，以 确保可持续的研究能力建设。我们还将鼓励点对点 在具有相同经验的科学家之间建立导师模式，以扩大影响 训练有素。国际导师仍将在当地的整体辅导中发挥关键作用 专家们，特别是扩大研究网络和提供赠款支持。 在这个为期5年的培训计划结束时，我们的总体目标是巩固一个核心团队 能够促进可持续能力建设的专家、多产、独立的科学家 通过获得外部资金，继续指导包括同龄人在内的其他人，并得到认可 作为艾滋病毒共同感染领域的国际、区域领导人和导师。

Increasing availability of antiretroviral therapy (ART) in sub-Saharan Africa (SSA) has led to decreases in mortality rates. The WHO estimates that 940,000 million deaths were attributable to HIV in 2017, with the majority caused by co-infecting pathogens. Uganda still has a prevalence rate of 6.5% among adults aged 15-49 (UNAIDS). Many patients still present late and often co-infected with opportunistic infections such as tuberculosis (TB) and cryptococcal meningitis. Viral hepatitis (B & C) co-infection occurs in 2-10% and poses challenges in terms of best anti-viral treatment, diagnosis, and prevention. Challenges present also for HIV-infected individuals stable on ART, because they are at higher risk of “non AIDS” non-communicable diseases, particularly hypertension, diabetes mellitus, renal disease, pulmonary disease, cardiovascular disease, cancer, bone abnormalities and liver failure. HIV infection itself also seems to be associated to an accelerated aging process. The Infectious Diseases Institute (IDI) in Uganda is a Research and Care Center of Excellence and has already established research programs in HIV and co-infections under the previous Heads of Research (Y. Manabe, and A Kambugu, previous Program Director and Uganda Program Director respectively). The current Head of Research (B Castelnuovo- proposed Program Director in this Cycle), has worked closely with Dr Manabe and Dr Kambugu for the last 10 years, when she was the Head of the Research Capacity Building Unit and Deputy Head of Research. We plan to train 9 master students, 2 PhD students and 5 post-doctoral students at Makerere University, Uganda. Our previous 5-year cycle has solidified a core group of productive, independent scientists through post-doctoral training who can now act as local mentors. We will shift the leadership of the training program from the US to the Uganda Institution in order to ensure sustainable research capacity building. We will also encourage a peer-to-peer mentorship model among scientists with the same level of experience to expand the impact of training. International mentors will still play a key role in overall mentorship of the local experts particularly to expand research networks and to provide grant-writing support. At the end of this 5-year training program, our overarching objective is to solidify a core group of expert, productive, independent scientists who can promote sustainable capacity building by garnering outside funding, continuing to mentor others including peers, and be recognized as international, regional leaders and mentors in the area of HIV co-infections.