Building independent research leaders in HIV-associated malignancies in Uganda

项目摘要/摘要 自从艾滋病广泛流行以来，艾滋病毒感染者中的癌症发病率每年都在增加 抗逆转录病毒治疗的可用性。癌症现在是艾滋病毒阳性者的主要死亡原因，因为 与HIV阴性相比，HIV相关恶性肿瘤(HIVAM)确诊后的存活率较低 世界各地的癌症。在艾滋病毒和病毒致癌基因高度流行的地区，定义艾滋病 恶性疾病，如卡波西肉瘤、非霍奇金淋巴瘤和宫颈癌 对艾滋病毒感染者健康的最大威胁；非艾滋病定义为肝细胞癌 癌症、肺癌和肛门癌现在占HIVAM的50%。癌症需要新的治疗策略 在资源有限的情况下预防和治疗艾滋病毒携带者。 自2004年以来，弗雷德·哈钦森癌症研究中心(FHCRC)一直与乌干达 位于乌干达坎帕拉的癌症研究所(UCI)在HIVAM方面进行研究，并开发癌症新策略 治疗和预防。通过几笔久负盛名的培训赠款和与我们的 学术合作伙伴，华盛顿大学(UW)和马凯雷雷大学(MU)，我们已经培训了&gt；300 HIVAM研究和各级护理中的个人。主要线人采访学术界、政府和 乌干达的临床领导者发现，进行HIVAM研究的能力仍然存在差距，特别是与 初级调查员进行独立研究的能力。我们建议支持发展 乌干达HIVAM的研究领导者通过三个具体目标：1)扩大训练有素的研究队伍 通过授予博士学位，重点是临床试验和研究，在HIVAM领域处于领先地位 我们与Makerere大学健康科学学院(MakCHS)建立的计划；2)提供有针对性的 培训，以促进以前的高级学位学员成熟到独立成为调查人员 在乌干达的HIVAM；3)加强研究技能，扩大乌干达调查人员的社区 HIVAM通过已建立的同伴辅导职业发展计划。拟议的培训活动 建立在我们当前培训计划的经验基础上，并将由一名经验丰富的杰出人员监督 代表来自美国和乌干达的艾滋病毒和肿瘤学研究领袖的委员会。

PROJECT SUMMARY / ABSTRACT The incidence of cancer among persons with HIV infection has increased annually since the widespread availability of antiretroviral therapy. Cancer is now a leading cause of death among HIV-positive persons, as survival after a diagnosis of an HIV-associated malignancy (HIVAM) is poorer compared with HIV-negative cancers across the world. In regions with a high prevalence of both HIV and viral oncogens, AIDS-defining malignancies such as Kaposi Sarcoma, non-Hodgkin lymphoma and cervical cancer present some of the largest threats to the health of HIV-infected individuals; non-AIDS defining cancers such at hepatocellular carcinoma, lung cancer and anal cancer now comprise >50% of HIVAM. New strategies are needed for cancer prevention and treatment among persons living with HIV in resource-limited settings. Since 2004, the Fred Hutchinson Cancer Research Center (FHCRC) has collaborated with the Uganda Cancer Institute (UCI) in Kampala, Uganda, to conduct research in HIVAM and develop new strategies for cancer treatment and prevention. Through several well-established training grants and strong relationships with our academic partners, the University of Washington (UW) and Makerere University (MU), we have trained >300 individuals in HIVAM research and care at all levels. Key informant interviews with academic, governmental and clinical leaders in Uganda find that gaps in the capacity to conduct HIVAM research persist, particularly related to junior investigators' abilities to conduct independent research. We propose to support the development of research leaders in HIVAM in Uganda through three Specific Aims: 1) Expand the cadre of trained research leaders in the field of HIVAM by conferring doctoral degrees with an emphasis on clinical trials research through our established program with the Makerere University College of Health Sciences (MakCHS); 2) Provide targeted training to facilitate the maturation of previous advanced degree trainees to independence as investigators in HIVAM in Uganda; 3) Strengthen the research skills and expand the community of Uganda investigators in HIVAM through an established Peer Mentoring Career Development program. The proposed training activities build on experiences with our current training programs and will be overseen by an experienced and outstanding committee representing leaders in HIV and oncology research from the US and Uganda.