Central Nervous System Infections in Peru

描述(由申请人提供)：这份R21申请书建议进一步发展华盛顿大学和秘鲁唯一的第三级神经疾病转诊中心--神经病学研究所(ICN)之间的研究合作。这笔赠款的主要目标将是开展必要的试点研究，为规划和准备申请资助影响秘鲁人的中枢神经系统感染研究提供信息，重点是：1)艾滋病毒/艾滋病和艾滋病毒混合感染；2)急性病毒性脑膜脑炎。目前由威斯康星大学领导的秘鲁艾滋病毒/艾滋病研究得到了美国国立卫生研究院和一家名为惠康信托的私人基金会的支持，并为神经艾滋病研究计划的发展提供了良好的基础。特别令人感兴趣的将是与艾滋病相关的中枢神经系统合并感染的发病机制、临床流行病学和管理研究，包括脑囊虫病，这是一种在秘鲁非常常见和研究得很好的疾病，以及耐多药结核病，它影响利马43%的艾滋病毒感染者和结核病患者。秘鲁也为热带脑膜脑炎的研究提供了一个很好的机会，利用了最近建立的全球新兴感染监测(GELS)系统，该系统由位于秘鲁的美国海军医学研究中心支队(NMRCD)协调，该系统提供了利用增加急性脑膜脑炎哨点监测的独特机会。与德克萨斯大学加尔维斯顿分校的研究人员合作，这种系统可以支持未来对秘鲁热带病毒性脑膜脑炎新出现问题的临床流行病学研究，如登革热和西尼罗河病毒。在最初一年的年初，我们将在我们的外部咨询委员会以及一组国际公认的合作调查员和秘鲁调查员的协助下，举办研究讲习班，以评估ICN与神经艾滋病和急性脑膜脑炎有关的研究、教育、培训和指导需求和机会；随后不久将制定初步研究议程，并启动相关的试点研究。第二年将用于完成和分析这些试点研究，并准备R01申请。

DESCRIPTION (provided by applicant): This R21 application proposes further development of research collaborations between the University of Washington and the Instituto de Ciencias Neurologicas (ICN), the only tertiary referral center for neurologic disease in Peru. The primary goal of this grant will be to carry out necessary pilot studies to inform the planning and preparation for an application for funding of research on CNS infections affecting Peruvians, emphasizing: 1) HIV/AIDS and HIV co-infection; and 2) acute viral meningoencephalitis. Current UW-led HIV/AIDS research in Peru is supported by NIH, and from a private foundation, the Wellcome Trust, and provides an excellent foundation for development of a NeuroAIDS research program. Of particular interest will be research on the pathogenesis, clinical epidemiology, and management of AIDS-related co-infections of the CNS, including neurocysticercosis a very common and well studied condition in Peru and multidrug-resistant tuberculosis, which affects 43% of HIV-infected individuals with TB in Lima. Peru also provides a good opportunity for research on tropical meningoencephalitis, capitalizing on a recently established Global Emerging Infections Surveillance (GELS) system coordinated by the U.S. Navy Medical Research Center Detachment (NMRCD) in Peru, which provides the unique opportunity to leverage addition of sentinel surveillance for acute meningoencephalitis. In collaboration with investigators at the University of Texas-Galveston, such a system could support future research on clinical epidemiology of emerging problems in tropical viral meningoencephalitis, such as dengue and West Nile viruses, in Peru. At the beginning of the initial year, with the assistance of our External Advisory Committee, and a team of internationally-recognized co-investigators and Peruvian investigators, we will conduct research workshops to assess research, education, training, and mentoring needs and opportunities related to NeuroAIDS and acute meningoencephalitis at the ICN; followed soon by development of a preliminary research agenda and initiation of relevant pilot studies. The second year will be used to complete and analyze these pilot studies and prepare the R01 application.