HIV and HCC in Africa: The H2A Consortium

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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.