AIDS INTERNATIONAL TRAINING AND RESEARCH PROGRAM

华盛顿大学国际艾滋病研究和培训方案于1985年启动，重点是艾滋病毒-1流行病学和预防的多学科研究，肯尼亚是主要目标国家。在过去的12年里，已经为肯尼亚科学家提供了66个在西雅图接受研究培训的培训任命，为美国研究人员提供了24个在肯尼亚接受实地研究经验的任命。IARTP的学者已经进行了大量的研究，肯尼亚艾滋病毒/性病研究项目已经成为艾滋病毒-1研究的卓越中心。通过目前的补充申请，我们希望促进肯尼亚HHV-8研究卓越中心的发展。在撒哈拉以南非洲的许多地区，HHV-8是一种非常普遍的传染病，在一般成人人口调查中，其血清阳性率约为50%。随着HIV-1的流行，卡波西肉瘤的发病率增加了10倍，现在已成为一些国家成人和儿童的主要恶性肿瘤。尽管HHV-8具有广泛的性质和相关的恶性肿瘤负担，但对该病毒的流行病学，包括传播方式知之甚少。我们最近在蒙巴萨妓女的PAVE/HIVNET前瞻性队列研究中启动了HHV-8的试点研究。我们发现HHV- 5的血清患病率为66%，血清发病率为每年2.1%，感染的相关性包括几个高危性行为指标。为了进一步解决HHV-8的异性传播问题，我们提出了一项建议，以确定HHV-8的血清阳性率、血清发病率、感染的相关性、血清转换疾病的特征以及包括宫颈、阴道和唾液样本在内的各个隔间的病毒检测频率。该研究项目将成为我们HHV-8研究培训计划的基础。已经确定了三个有兴趣获得HHV-8专业知识的候选人。MS Bhavna Chohan是蒙巴萨HIV/STD研究实验室的实验室技术主管，她将于2000年作为高级国内学者项目的一部分来华盛顿大学接受为期两个月的HHV-8诊断方法的实验室培训，随后于2001年在微生物系接受博士培训。George Ogweno，医学博士，过去两年负责妓女队列研究临床行为的医生，今年夏天将来华盛顿大学1-2个月，参加性病/艾滋病研究原理强化课程，并接受生物统计学入门培训，之后他将于2001年返回流行病学系攻读公共卫生硕士学位课程。医学博士Melanie Taylor是华盛顿大学的传染病研究员，她将于9月前往蒙巴萨进行为期一年的研究，以获得HHV-8妓女研究的实地研究经验。Drs。Joan Kreiss, Lawrence Corey, Rhoda Ashley, Ludo Lavreys， Barbra Richardson和Kishorchandra mandalya将是参与HHV-8研究培训的主要教员。本补充申请的目的是提高我们对HHV-8流行病学的了解，以便制定合理的干预措施来预防传播，并通过研究培训和加强基础设施，促进肯尼亚HHV-8研究卓越中心的发展。

The University of Washington International AIDS Research and Training Program was initiated in 1985 and has focused on multidisciplinary research on HIV-1 epidemiology and prevention, with Kenya being the primary target country. Over the past 12 years,66 training appointments have been provided for Kenyan scientists to receive research training in Seattle and 24 appointments have been provided for US investigators to receive field research experience in Kenya. A significant body of research has been conducted by IARTP scholars and the Kenya HIV/STD Research Project has emerged as a center for excellence in HIV-1 research. With the current supplement application, we hope to foster the development of a Kenyan center for excellence in HHV-8 research. HHV-8 is a very prevalent infectious disease in many parts of sub- Saharan Africa, with seroprevalence rates of approximately 50% in general adult population surveys. Kaposi's sarcoma incidence has increased >10 fold in conjunction with the HIV-1 epidemic, and is now the leading malignancy in adults and children in some countries. Despite the widespread nature of HHV-8 and the associated burden of malignancy, little is known about the epidemiology of the virus, including modes of transmission. We recently initiated pilot studies of HHV-8 within our PAVE/HIVNET prospective cohort study of prostitutes in Mombasa. We found the HHV- 5 seroprevalence to be 66%, seroincidence to be 2.1% per year, and correlates of infection to include several indices of high-risk sexual behavior. To further address the issue of heterosexual transmission of HHV-8, we developed a proposal to determine HHV-8 seroprevalence, seroincidence, correlates of infection, characteristics of a seroconversion illness, and frequency of viral detection in various compartments including cervical, vaginal, and salivary samples. This research project will form the basis of our HHV-8 research training plan. Three candidates with an interest in acquiring expertise in HHV-8 have been identified. Bhavna Chohan, MS, the laboratory technologist supervisor of the HIV/STD Research Laboratory in Mombasa, will come to the UW for laboratory training in HHV-8 diagnostic methods for 2 months in 2000 as part of an Advanced In-Country Scholar program, followed by PhD training in the Department of Microbiology in 2001. George Ogweno, MD, the physician who has been responsible for the clinical conduct of the prostitute cohort study for the past 2 years, will come to the UW for 1-2 months this summer to attend the Principles of STD/HIV Research intensive course and receive introductory training in biostatistics, after which he will return in 2001 for an MPH degree course in the Department of Epidemiology. Melanie Taylor, MD, an infectious disease fellow at the UW, will go to Mombasa in September for a one year period to gain field research experience with the HHV-8 prostitute study. Drs. Joan Kreiss, Lawrence Corey, Rhoda Ashley, Ludo Lavreys, Barbra Richardson, and Kishorchandra Mandaliya will be key faculty members involved with training in HHV-8 research. The goal of this supplement application is to improve our understanding of HHV-8 epidemiology to enable the development of rational interventions to prevent transmission, and to foster the development of a center for excellence in HHV-8 research in Kenya through research training and infrastructure strengthening.