Core B: Data and Statistics Core

艾滋病毒和疟疾是世界上两种最重要的传染病，在亚区域和区域内具有协同作用。 撒哈拉非洲。本计划项目（P01）的总体目标是评估新的和战略性的 采取干预措施，减少疟疾负担，改善儿童和孕妇艾滋病毒感染情况 妇女是受这些疾病重叠影响最严重的人群。 我们假设用HIV蛋白酶抑制剂（Pis）治疗可以降低疟疾的发病率， 感染艾滋病毒的儿童和孕妇与接受标准 抗逆转录病毒治疗这一假设是基于疟疾寄生虫和艾滋病毒表达的理解， 生物化学上相似的蛋白酶和HIV Pis在体外发挥有效的抗疟活性的观察。 其次，我们假设，在未感染艾滋病毒的儿童中，化学预防治疗将提供强有力的保护 在干预措施停止后，疟疾发病率不会增加。三是 假设间歇性或慢性抗疟和基于PI抗逆转录病毒疗法将选择药物 不同的药物将提供不同的选择压力。四项相互关联的研究， 测试这三个假设组成了我们的P01项目： 1：蛋白酶抑制剂用于预防艾滋病毒感染儿童的疟疾 2：蛋白酶抑制剂降低感染艾滋病毒的孕妇的疟疾发病率 3：未感染艾滋病毒的婴儿和儿童的疟疾化学预防疗法 4：通过抗疟和艾滋病毒疗法选择抗药性疟疾寄生虫 这些项目将招收共1600名参与者，并由一个多学科，跨国 在乌干达的托罗罗，一个高疟疾传播的地方。行政和数据/统计核心将 支持4个项目。这些项目将在行之有效的疟疾预防战略范围内进行 这是目前大多数撒哈拉以南非洲国家的标准护理：1）使用化学预防， 艾滋病毒感染儿童和孕妇使用甲氧苄啶-磺胺甲恶唑，以及2）使用杀虫剂 治疗网我们的主要目标是在现有知识的基础上建立新的方法， 该项目旨在减轻撒哈拉以南非洲的艾滋病毒和疟疾负担，并推动对这两种疾病采取公共卫生办法。

HIV and malaria are two of the most important infectious diseases worldwide, and are synergistic in sub- Saharan Africa. The overarching goal of this program project (P01) is to evaluate novel and strategic interventions to reduce the burden of malaria and improve HIV outcomes among children and pregnant women, the populations most affected by the overlap of these diseases. We hypothesize that treatment with HIV protease inhibitors (Pis) will lower the incidence of malaria and consequent morbidity in HIV-infected children and pregnant women compared to those treated with standard antiretroviral treatment. This hypothesis is based on the appreciation that malaria parasites and HIV express biochemically similar proteases and the observation that HIV Pis exert potent in vitro antimalarial activity. Second, we hypothesize that in HIV-uninfected children, chemopreventive therapy will offer strong protection against malaria without increased malarial morbidity after discontinuation of the intervention. Third, we hypothesize that intermittent or chronic antimalarial and Pi-based antiretroviral therapy will select for drug resistant parasites, and that different drugs will offer different selective pressures. Four interlinked studies to test these three hypotheses comprise our P01 projects: 1: Protease inhibitors for the prevention of malaria in HIV-infected children 2: Protease inhibitors to reduce malaria morbidity in HIV-infected pregnant women 3: Chemopreventive therapy for malaria in HIV-uninfected infants and children 4: Selection of drug resistant malaria parasites by antimalarial and HIV therapies The projects will enroll a total of 1600 participants and be implemented by a multidisciplinary, multinational team in Tororo, Uganda, a site of high malaria transmission. Administrative and data/statistics cores will support the 4 projects. The projects will be conducted in the context of proven malaria preventive strategies that are currently the standard of care for most of sub-Saharan Africa: 1) the use of chemoprophylaxis with trimethoprim-sulfamethoxazole in HIV-infected children and pregnant women, and 2) the use of insecticide treated nets. Our primary goal will be to build on current knowledge to establish new approaches to reduce HIV and malaria burden in sub-Saharan Africa, and to advance the public health approach to both diseases.