AMPATH-Oncology Institute: HPV and Cervical Cancer in Kenyan Women with HIV/AIDS

人乳头瘤病毒（HPV）与人免疫缺陷病毒（HIV）的相互作用代表了以下因素之一： 对撒哈拉以南非洲的女性来说，这是最危险的关系。在高收入国家， 这些高危HPV（HR-HPV）中有HPV 16和18，它们是两种市售HPV疫苗的靶点。 二价和四价疫苗。然而，更广泛的HR-HPV类型和更高的发病率， 在低收入至中等收入国家（LMC）的妇女中报告了多种HPV感染。 据估计，全世界每年诊断出超过500，000例宫颈癌，其中85%的人患有宫颈癌。 这些在LMC中。在非洲，大约有8万名妇女被诊断患有宫颈癌，6万人死亡。 每年从这种疾病中，使其成为妇女癌症死亡的主要原因。 撒哈拉以南非洲地区也包含了世界上70%的艾滋病毒诊断病例，肯尼亚是非洲最严重的艾滋病毒感染者之一。 震中最近的研究表明，艾滋病毒显然是宫颈癌发生的一个促成因素; 女性HPV感染的发病率和持续性更高， 宫颈癌和宫颈上皮内瘤变（CIN）的发病率较高。这些"完美风暴" 这两个病毒家族只是开始解释为什么在亚热带地区宫颈癌的发病率和死亡率都很高， 撒哈拉非洲是美国的三倍。其他共病因素，如性 传播感染、环境问题、抗逆转录病毒疗法和其他疗法， HR-HPV致癌作用，需要进一步研究，如果要在宫颈癌中产生重大影响。 本申请的核心目的是更好地了解致癌HPV感染的自然史 感染艾滋病毒的肯尼亚妇女，以及潜在的可改变（和不可改变）的因素， 与致癌HPV感染进展为临床疾病相关，包括宫颈癌。 此外，随着名为AMPATH肿瘤学的跨国跨学科项目的创建， 研究所，将建立一个指导计划，以促进肯尼亚新癌症研究人员的发展。 我们的预期成果是建立一个专注于癌症的肯尼亚调查人员核心， 体现了转化和合作研究的文化。

The interaction of human papillomavirus (HPV) with human immunodeficiency virus (HIV) represents one of the most "dangerous liaisons" for women in Sub-Saharan Africa. In high-income countries, the most common of these high-risk HPVs (HR-HPVs) are HPV 16 and 18, which are the targets of two commercially available bivalent and quadrivalent vaccines. However, a wider spectrum of HR-HPV types and a higher incidence of multiple HPV infections have been reported in women from low- to middle-income countries (LMCs). Worldwide, it is estimated that over 500,000 cases of cervical cancer are diagnosed yearly, with 85% of these in LMCs. In Africa, approximately 80,000 women are diagnosed with cervical cancer and 60,000 die from the disease annually, making it the leading cause of cancer death among women. Sub-Saharan Africa also contains 70% of the world's diagnosed cases of HIV, with Kenya as one of Africa's epicenters. Recent studies show that HIV is clearly a contributing factor for cervical carcinogenesis; HIVinfected women have a greater incidence and persistence of HPV infections and suffer from a markedly higher incidence of cervical cancer and cervical intraepithelial neoplasia (CIN). The "perfect storm" of these two families of viruses only begins to explain why both incidence and mortality of cervical cancer in Sub- Saharan Africa are three-fold that of the United States. Other co-morbidity factors, such as sexually transmitted infections (STIs), environmental issues, anti-retroviral and other therapies, and their relation to HR-HPV carcinogenesis, need further study if a major impact is to be made in cervical cancer. The core objective of this application is to better understand the natural history of oncogenic HPV infections in HIV-infected Kenyan women, and the potentially modifiable (and non-modifiable) factors that are associated with progression of oncogenic HPV infection to clinical disease, including cervical cancer. Additionally, with the creation of a multinational, transdisciplinary program entitled the AMPATH-Oncology Institute, a mentoring program will be established to foster development of new cancer researchers in Kenya. Our expected outcome is the establishment of a dedicated core of cancer-focused Kenyan investigators who embody a culture of translational and collaborative research.