Building Capacity for Patient Oriented Research in HIV-associated Kaposi Sarcoma

描述（由申请人提供）：卡波西肉瘤（KS）和非霍奇金淋巴瘤（NHL）是恶性肿瘤，在HIV感染不受控制的情况下，发病率明显增加，发病率和死亡率也很高。在受艾滋病毒影响的低收入和中等收入国家，与艾滋病毒有关的恶性肿瘤发病率有所上升，而夸祖鲁-纳塔尔省是全球艾滋病毒/艾滋病流行的中心。初步数据表明，该省这两种恶性肿瘤的疾病负担很大。此外，由于合并结核病（TB）的沉重负担，KZN的艾滋病毒相关恶性肿瘤的管理变得复杂。在资源有限的环境中，迫切需要研究改善这些艾滋病毒相关恶性肿瘤的预防和治疗策略。这项培训补助金的目标是进一步发展研究能力，以便在与艾滋病毒有关的恶性肿瘤领域，在面向病人的临床研究和面向公共卫生的流行病学研究方面，提高平行的专门知识。为了实现这些目标，我们将培训一名以流行病学为重点的博士后实习生和一名以临床研究为重点的博士后实习生，研究流行病学和生物统计学方法，以发展当地设计和分析以患者为导向的研究的能力。我们还将培训一名博士生，学习卡波西肉瘤疱疹病毒（KSHV）和艾滋病毒病毒学实验室方法，以培养当地生物标志物研究方面的专业知识，目标是将这些专业知识应用于临床和流行病学研究。培训将包括哥伦比亚大学和夸祖鲁-纳塔尔大学（UKZN）的课程，哥伦比亚大学在UKZN的教师讲授的模块化课程，以及结构化的指导。此外，我们将试点为初级保健提供者举办两个讲习班，目的是增加南非黑人中与艾滋病毒相关的KS的早期发现。通过这项培训拨款，我们希望扩大核心研究人员的研究能力，在资源有限的情况下，对艾滋病毒相关的KS和NHL进行预防、早期检测和改进治疗。公共卫生相关性：在受艾滋病毒影响的低收入和中等收入国家，与艾滋病毒相关的恶性肿瘤发病率有所上升，而科索沃民主共和国是全球艾滋病毒/艾滋病流行的中心。KZN地区hiv相关KS和NHL的发病率和死亡率很高，迫切需要在资源有限的环境中研究改善这些hiv相关恶性肿瘤的预防和治疗策略。

DESCRIPTION (provided by applicant): Kaposi sarcoma (KS) and non-Hodgkin's lymphoma (NHL) are malignancies with markedly increased incidence as well as high morbidity and mortality in the setting of uncontrolled HIV infection. Rates of HIV associated malignancies have increased in low- and middle- income countries affected by the HIV, and KwaZulu-Natal (KZN) is the epicenter of the global HIV/AIDS epidemic. Preliminary data suggest a large burden of disease for these two malignancies in the province. Furthermore, management of HIV-associated malignancies in KZN is complicated by the heavy burden of co-morbid tuberculosis (TB). Research towards improved prevention and treatment strategies for these HIV-associated malignancies in resource-limited settings is urgently needed. The objectives of this training grant are to further develop research capacity so as to advance parallel expertise in both patient-oriented clinical research and public-health oriented epidemiologic studies in the field of HIV-associated malignancies. Towards these objectives, we will train one postdoctoral trainee with an epidemiology focus and one postdoctoral trainee with a clinical research focus in the epidemiology and biostatistics methodologies necessary to develop the local capacity to design and analyze patient-oriented studies. We will also train one predoctoral student in Kaposi sarcoma herpes virus (KSHV) and HIV virologic laboratory methods appropriate for developing local expertise in biomarker studies, with the goal of applying this expertise in both clinical and epidemiologic research. Training will consist of coursework at Columbia University and University of KwaZulu-Natal (UKZN), modular sessions taught by Columbia University faculty at UKZN, and structured mentorship. Furthermore, we will pilot two workshops for primary care providers with the goal of increasing early detection of HIV-associated KS in Black South Africans. Through this training grant, we hope to expand a core of researchers capable of studies in the prevention, early detection and improved treatment of HIV-associated KS and NHL in resource-limited settings. PUBLIC HEALTH RELEVANCE: Rates of HIV-associated malignancies have increased in low- and middle- income countries affected by the HIV, and KZN is the epicenter of the global HIV/AIDS epidemic. Morbidity and mortality from HIV-associated KS and NHL in KZN is high, and research towards improved prevention and treatment strategies for these HIV-associated malignancies in resource-limited settings is urgently needed.