HIV and HCC in Africa: The H2A Consortium

肝细胞癌（HCC）是一种非常常见和致命的癌症在非洲，并与艾滋病毒感染者的生活 时间越长，HCC的负担可能会增加。在先前的研究中，我们的团队确定了慢性B型肝炎感染 C病毒（HBV、HCV）、HIV和曼氏血吸虫是HCC的独立危险因素。相比 对于美国，撒哈拉以南非洲的HCC发生在更年轻和更晚期的阶段， 个月建议在马凯雷雷大学的同事之间建立东非和西非伙伴关系， 乌干达、塞内加尔的法恩大学和约翰霍普金斯大学专注于艾滋病毒和肝细胞癌 非洲的肝癌（HCC）：H2 A联盟。建立在长期的合作研究，指导 在这两个国家的临床活动，我们的总体目标是减少肝癌的沉重负担， 撒哈拉非洲。我们提倡使用适当的药物治疗来研究癌症拦截策略 以中断或逆转这些导致HCC的感染的影响。我们将通过以下方式实现这一目标： 发展地方能力和进行重要的研究。联合会的活动旨在加强 临床、人口和转化研究基础设施以及非洲个体研究者的能力 对艾滋病毒、慢性感染和HCC进行高水平的合作调查。首先，我们将形成一个大的， HBV和HBV/HIV合并感染者的前瞻性队列，以确定谁需要HBV治疗，确定 临床反应，并表征突破性HCC，同时研究新的生物标志物。了解 我们的数据表明慢性HBV和Sm感染之间的协同作用，我们将研究HBV 临床和免疫反应在周边和肝脏中响应Sm治疗。艾滋病毒是 在这两个项目中作为这些关系的关键修改器进行调查。结合我们的科学议程， 早期的非洲调查人员将在进行调查的同时， 利用联合会资源的合作试点项目。我们的综合研究和 能力发展活动将是建立H2 A联盟，作为合作中心， 东非和西非艾滋病毒和肝癌卓越项目。

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. We will accomplish this objective by developing local capacity and performing important research. 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. First, we will form a large, prospective cohort of HBV and HBV/HIV co-infected persons to define who needs HBV treatment, determine clinical responses, and characterize breakthrough HCC, while investigating novel biomarkers. To understand our data demonstrating synergistic interaction between chronic HBV and Sm infections, we will examine HBV clinical and immunological responses in the periphery and the liver in response to Sm treatment. HIV is investigated as a key modifier of these relationships in both projects. Integrated within our scientific agenda, early-stage African investigators will be provided mentoring and career development support while conducting a collaborative pilot project leveraging Consortium resources. The impact of our integrated research and capacity development activities will be establishment of the H2A Consortium as partnered Centers of Excellence on HIV and HCC in East and West Africa.