Project 1

这项申请是为了建立北卡罗来纳-马拉维癌症联盟(UNC-MCC)，以发展能力并开展以艾滋病毒相关癌症为重点的高影响力研究。该联盟建立在北卡罗来纳大学教堂山分校(UNC-CH)、灯塔信托基金、马拉维卫生部和马拉维大学医学院之间的长期合作基础上。这些伙伴关系为撒哈拉以南非洲的艾滋病毒护理和预防作出了国际公认的贡献。这一基础设施现在可以用于艾滋病毒相关的恶性肿瘤。UNC-MCC专注于疱疹病毒相关癌症、卡波西肉瘤(KS)和淋巴瘤。我们的财团将由三名具有高度互补性的专业知识的主要研究人员领导(萨蒂什·戈帕尔医学博士，临床研究；萨姆·菲里博士，实施科学；Blossom Damania博士，病毒学)。北卡罗来纳大学-MCC正在开展的三个研究项目中的第一个是利用马拉维国家癌症登记中心(MNCR)进行的艾滋病毒-癌症记录联系研究。该项目由三位共同的私人投资机构领导，分别是Charles Dzamalala博士(MNCR主任)、Kennedy Malisita博士(伊丽莎白中心医院抗逆转录病毒治疗诊所主任)和Andy Olshan博士(北卡罗来纳大学-CH分校流行病学系教授兼主任)。该项目利用马拉维境内一套独特的资源，包括一个以人口为基础的国家癌症登记册，这是目前纳入世卫组织癌症发病率专著的仅有的四个撒哈拉以南非洲国家癌症登记册之一，以及详细、纵向地描述大量患者的艾滋病毒队列。结合这些资源为了解抗逆转录病毒(ART)治疗(包括疱疹病毒相关癌症)中癌症风险可能发生的变化提供了难得的机会。在撒哈拉以南非洲，这在很大程度上仍然是未知的，马拉维甚至在2004年开始扩大抗逆转录病毒治疗后也没有观察到发病率的下降。这项研究将在国际艾滋病评估流行病学数据库(IeDEA)的技术援助下，使用概率匹配方法将大型国家数据集联系起来，该网络曾在南非赞助过有记录的关联研究。这项工作预计将产生该地区艾滋病毒相关恶性肿瘤研究的最佳流行病学资源之一，以更好地了解当前的趋势，并帮助根据高质量的当地数据确定马拉维境内资源的优先顺序。

This application is to establish the UNC-Malawi Cancer Consortium (UNC-MCC), to develop capacity and conduct high-impact research focused on HIV-associated cancers. The consortium builds on longstanding collaborations between the University of North Carolina at Chapel Hill.(UNC-CH), Lighthouse Trust, Malawi Ministry of Health, and University of Malawi College of Medicine. These partnerships have resulted in internationally recognized contributions for HIV care and prevention in sub-Saharan Africa. This infrastructure can now be leveraged for HIV-associated malignancies. UNC-MCC is focused on the herpesvirus-associated cancers, Kaposi sarcoma (KS), and lymphoma. Our consortium will be led by three principal investigators with highly complementary expertise (Satish Gopal MD, clinical research; Sam Phiri PhD, implementation science; Blossom Damania PhD, virology). The first of three research projects being undertaken by UNC-MCC is an HIV-cancer record linkage study using the Malawi National Cancer Registry (MNCR). The project is led by three co-PIs, Drs. Charles Dzamalala (MNCR Director), Kennedy Malisita (Director, Antiretroviral Therapy Clinic, Queen Elizabeth Central Hospital), and Andy Olshan (Professor and Chair of the UNC-CH Department of Epidemiology). The project utilizes a unique set of resources within Malawi, including a population-based national cancer registry which is one of only four from sub-Saharan Africa to be included in the current WHO cancer incidence monograph, and HIV cohorts with detailed, longitudinal characterization of large numbers of patients. Combining these resources presents a rare opportunity to understand how cancer risk may be changing in the antiretroviral (ART) therapy, including for herpesvirus-associated cancers. This is still largely unknown in sub-Saharan Africa, and declines in incidence have not yet been observed in Malawi even after ART scale-up began 2004. The study will be conducted using probabilistic matching methods to link large national datasets, with technical assistance from the International Epidemiologic Databases to Evaluate AIDS (IeDEA) network, who have sponsored prior record linkage studies in South Africa. This work is anticipated to result in one of the best epidemiologic resources in the region for HIV-related malignancies research, to better understand current trends, and assist in prioritization of resources within Malawi based on high-quality local data.