Antiviral treatment as prevention for HBV- and HBV/HIV-associated hepatocellular carcinoma

肝细胞癌在非洲是一种非常常见和致命的癌症，作为艾滋病毒携带者的患者生活在非洲。 时间长了，肝细胞癌的负担可能会增加。在之前的研究中，我们的团队确认了慢性乙肝感染 C病毒(乙肝病毒、丙型肝炎病毒)、HIV和曼氏血吸虫病是肝细胞癌的独立危险因素。相比较 对美国来说，撒哈拉以南非洲的肝癌发生在较年轻和较晚期的患者中，仅 月份。Makerere大学的同事们提议在东非和西非建立伙伴关系 乌干达、塞内加尔范恩大学和约翰霍普金斯大学专注于艾滋病毒和肝细胞 非洲的癌症(肝癌)：H_2A联盟。建立在长期合作研究、指导的基础上 和临床活动，我们的首要目标是减轻亚洲区的肝癌负担 撒哈拉非洲。我们主张使用适当的医疗手段研究癌症拦截策略。 以阻断或逆转这些引起肝癌的感染的影响。财团活动旨在 加强临床、人口和转化性研究基础设施和非洲个人 调查员有能力对艾滋病毒、慢性感染和肝细胞癌进行高水平的协作调查。在……里面 在这个项目中，我们将形成一个庞大的、预期的乙肝病毒和乙肝病毒/艾滋病毒混合感染者队列， 来自乌干达和塞内加尔的招聘。指南-针对乙肝病毒的适当抗病毒治疗将是 启动并使用超声和甲胎蛋白进行肝细胞癌监测。基线和六个月的研究 访问将收集问卷、临床、超声和弹性成像数据。我们将定义临床结果 从降低标准和新的病毒生物标志物、稳定和消退肝脏方面治疗乙肝 纤维化，并降低肝癌的发病率。同时，使用一种新的白蛋白吸入术方法，我们将 研究氧化应激途径的变化，并确定与乙肝病毒和艾滋病毒相关的新生物标志物 感染。对于这些分析中的每一项，艾滋病毒合并感染都被评估为关键的影响因素。网络的影响 这些研究将为治疗和筛查方法提供信息，并可能识别新的生物标记物 用于指导乙肝管理和肝细胞癌的预防。

Hepatocellular carcinoma (HCC) is a very common and lethal cancer in Africa, and as patients with HIV live longer, the HCC burden may increase. In prior studies, our team identified chronic infection with hepatitis B and C viruses (HBV, HCV), HIV and Schistosomiasis mansoni as independent risk factors for HCC. Compared to the US, HCC in sub-Saharan Africa occurs at younger age and more advanced stage with survival of only months. Proposed is an East and West African partnership between colleagues at Makerere University in Uganda, Fann University in Senegal and Johns Hopkins University focused on HIV and hepatocellular carcinoma (HCC) in Africa: The H2A Consortium. Building on long-standing collaborative research, mentoring and clinical activities in both countries, our overarching goal is to reduce the heavy burden of HCC in sub- Saharan Africa. We advocate investigating cancer interception strategies using appropriate medical treatments to interrupt or reverse the impact of these HCC-causing infections. Consortium activities are designed to enhance both the clinical, population and translational research infrastructure and individual African investigator capacity to conduct high-level, collaborative investigation of HIV, chronic infections and HCC. In this project, we will form a large, prospective cohort of HBV and HBV/HIV co-infected persons with balanced recruitment from both Uganda and Senegal. Guideline-appropriate antiviral treatment against HBV will be initiated and HCC surveillance with ultrasound and alpha-fetoprotein performed. Baseline and six-month study visits will collect questionnaire, clinical, ultrasound, and elastography data. We will define clinical outcomes of HBV treatment in terms of reduced standard and novel viral biomarkers, stabilization and regression of liver fibrosis, and reduced incidence of HCC. In parallel, using a novel albumin adductomics approach, we will investigate changes in oxidative stress pathways and identify novel biomarkers relevant for both HBV and HIV infections. For each of these analyses, HIV co-infection is evaluated as a key effect modifier. The impact of these studies will be to inform treatment and screening approaches and potentially identify novel biomarkers for guiding HBV management and HCC prevention.