Kaposi Sarcoma in the Era of ART in Africa Program (KEAAP)

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There are currently over 1.2 million people in Zambia and 1.7 million in Tanzania who are living with HIV/AIDS. Concomitant to the HIV epidemic, there is a high incidence of HIV/AIDS-associated malignancies (HIVAM) in these two countries. Even in this era of antiretroviral therapy (ART) Kaposi sarcoma (KS) has remained one of the most common HIVAM. This underscores a critical need for research in the context of ART-mediated changes in the HIV epidemic so that we are better equipped to diagnose, manage, and prevent KS in sub- Saharan Africa (SSA). To address this need, the overall vision of the “Kaposi Sarcoma in the Era of ART in Africa Program (KEAAP)” is to build a collaborative network between the Cancer Diseases Hospital (CDH) and University Teaching Hospitals (UTH) in Zambia, the Ocean Road Cancer Institute (ORCI) in Tanzania, and the Stanley S Scott Cancer Center at the Louisiana State University Health Sciences Center-New Orleans (LSUHSC-NO) to conduct cutting edge research that will lead to a better understanding of KS, and in parallel, continue to enhance HIVAM and non-HIVAM research capacity in Zambia and Tanzania to meet the needs of the cancer patients. KEAAP’s theme centers on the research gaps of the KS disease spectrum, from detection, to care and outcomes, to deciphering KS pathogenesis and immune response towards achieving KEAAP’s overall goal to prevent and curing the disease. KEAAP’s immediate objective is to further enhance the cancer research infrastructure in CDH/UTH and ORCI through support for interdisciplinary and bilateral KS research projects to address some of the research gaps in SSA: 1) KS diagnosis and disease staging, and linking to care; 2) changes in the immune response and metabolomes in KS patients upon treatment; and 3) identification and characterization of KSHV tissue reservoirs, and the effects of ART and HIV on these reservoirs. This proposed consortium will provide diverse training activities in the U.S., Zambia, and Tanzania to engage the next generation of low and middle income countries (LMICs) and U.S. cancer researchers, increase local expertise, and enhance the transfer of technology. KEAAP’s goal will be accomplished through the completion of three specific aims:1) Develop the cancer research infrastructure at UTH/CDH and ORCI through the establishment and enhancement of three core facilities; 2) Provide an opportunity for former Fogarty trained fellows to lead three hypothesis-driven KS research projects; 3) Develop a pipeline of next- generation U.S. and LMICs cancer researchers through a) in-country workshops, b) pilot project funding, and c) short-term U.S. and in-country training. KEAAP is high impact because it builds on successful ongoing Fogarty and NCI training programs; it will implement a cross-disciplinary and tri-lateral research and training program that are driven by our Tanzanian and Zambian collaborators with broad local support to ensure their sustainability. The lessons learned will also benefit Louisiana HIV-1 and cancer research since the state has the fifth largest population of people living with HIV, mostly among its health disparities population.