CNS Involvement in the HIV Population in Ethiopia: A Post-mortem Forensic Study

描述（由申请人提供）：埃塞俄比亚首都亚的斯亚贝巴的艾滋病毒感染率预计约为15.6%，没有关于艾滋病毒和艾滋病毒相关疾病如何影响埃塞俄比亚人口中枢神经系统的信息。这项前瞻性神经病理学研究的主要科学目标是确定亚的斯亚贝巴HIV尸检病例大脑中中枢神经系统受损伤的频率和独特特征。实现科学目标将：1)转移技术，教育和培训埃塞俄比亚的病理学家使用尸检材料来诊断和病理表征艾滋病毒和与艾滋病毒相关的中枢神经系统的参与，2)创建一个永久的资源来记录不同疾病阶段的艾滋病毒患者的病理特征，3)建立临床诊断或疑似艾滋病毒的病理证实。目标1：建立亚的斯亚贝巴大学医学院和加州大学圣地亚哥分校之间的合作系统，收集埃塞俄比亚人口的尸检组织，以1)确定HIV感染的百分比和2)HIV相关的中枢神经系统机会性感染和/或肿瘤。目的II：确定本研究中HIV阳性患者中结核分枝杆菌累及中枢神经系统的频率，并描述与HIV中枢神经系统病理相关的中枢神经系统结核的病理模式。为此目的，将从200例法医学法医病理学成人尸检病例中收集死后中枢神经系统组织，这些病例包括亚的斯亚贝巴埃塞俄比亚人口的广泛横截面，包括突然死亡和先前疾病造成的死亡。将对组织进行神经病理学诊断，以确定HIV和HIV相关的中枢神经系统受累的模式。一个数据库描述患者的人口统计，并包括组织切片与详细的神经病理诊断将被构建。这些研究将首次提供埃塞俄比亚HIV神经发病机制自然史的神经病理学特征。加州大学圣地亚哥分校和亚的斯亚贝巴大学医学院之间的这一合作努力将为埃塞俄比亚医务人员的艾滋病毒神经发病机制教育提供永久和可扩展的技术资源，从而有助于实现提高埃塞俄比亚研究能力的总体目标。增加对艾滋病毒神经致病机制的了解将有助于改善埃塞俄比亚艾滋病毒患者的治疗和管理。

DESCRIPTION (provided by applicant): HIV infection in Addis Ababa, the capital city of Ethiopia, is projected to be approximately 15.6% and no information exists on how HIV and HIV-related diseases impact the CNS of the Ethiopian population. The main scientific objectives of this prospective neuropathological study are to determine the frequency and unique characteristics of CNS involvement from the brains of HIV autopsy cases in Addis Ababa. Accomplishing the scientific objectives will: 1) transfer technology to educate and train pathologists in Ethiopia to use autopsy material for the diagnosis and pathological characterization of HIV and HIV- associated CNS involvement, 2) create a permanent resource for documenting pathological profiles of HIV patients at various stages of disease, and 3) establish pathological confirmation of clinical diagnosis or suspected HIV. AIM I: Establish collaborative system between Addis Ababa University School of Medicine and the University of California San Diego for the collection of autopsy tissues from the Ethiopian population to 1) determine the percentage of HIV infection and 2) HIV associated CNS opportunistic infections and/or neoplasms. AIM II: Determine the frequency of CNS involvement by M. tuberculosis in HIV+ patients from this study and describe pathological patterns of CNS tuberculosis in relation to HIV CNS pathology. For this purpose, post-mortem CNS tissues will be collected from 200 Medico-legal Forensic Pathology adult autopsy cases that consist of a broad cross-section of the Ethiopian population in Addis Ababa and will include both sudden deaths and deaths from pre-existing illness. Tissues will be processed for neuropathological diagnoses to determine patterns of HIV and HIV-associated CNS involvement. A database describing patient demographics, and including tissue sections with detailed neuropathological diagnoses will be constructed. These studies will provide for the first time neuropathological characterization of the natural history of HIV neuropathogenesis in Ethiopian. This collaborative effort between the University of California San Diego and Addis Ababa University School of Medicine will contribute to the overall goal of increased research capacity in Ethiopia by providing a permanent and expandable technological resource for the education of medical personnel in Ethiopia regarding HIV neuropathogenesis. Increased understanding of HIV neuropathogensis will contribute to the improved treatment and management of HIV patients in Ethiopia.