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

人乳头瘤病毒(HPV)与人类免疫缺陷病毒(HIV)的相互作用是 对撒哈拉以南非洲的妇女来说，最危险的联系方式。在高收入国家，最常见的 在这些高危HPV(HR-HPV)中，HPV16和HPV18是两种商业可获得的靶标 二价和四价疫苗。然而，更广泛的HR-HPV类型和更高的发病率 据报告，低收入到中等收入国家(LMC)的妇女中存在多种HPV感染。 在世界范围内，据估计，每年有超过50万人被诊断为宫颈癌，其中85%的人 这些都是LMC。在非洲，大约8万名妇女被诊断出患有宫颈癌，6万人死亡 每年死于这种疾病，使其成为女性癌症死亡的主要原因。 撒哈拉以南非洲也有世界上70%的艾滋病毒确诊病例，肯尼亚是非洲的其中之一 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；艾滋病毒感染 女性感染HPV的几率和持久性更高，并患有明显的 宫颈癌和宫颈上皮内瘤变(CIN)的发病率较高。这其中的“完美风暴” 两个病毒家族只是开始解释为什么亚洲区宫颈癌的发病率和死亡率 撒哈拉非洲的人口是美国的三倍。其他共病因素，如性行为 传播感染、环境问题、抗逆转录病毒和其他疗法及其与 如果要对宫颈癌产生重大影响，则需要进一步研究HR-HPV的致癌机制。 此应用程序的核心目标是更好地了解致癌性HPV感染的自然病史。 在感染艾滋病毒的肯尼亚妇女中，以及潜在的可改变(和不可改变)的因素是 与致癌性HPV感染进展相关的临床疾病，包括宫颈癌。 此外，通过创建一个名为AMPATH-肿瘤学的跨国跨学科计划 该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。 我们预期的结果是建立一个专注于癌症的肯尼亚调查人员的专门核心 体现了翻译和协作研究的文化。

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.