Expanding independent research capacity in HIV-associated malignancies in Uganda

描述（由申请人提供）：自从抗逆转录病毒治疗广泛使用以来，艾滋病毒感染者的癌症发病率每年都在增加。癌症现在是艾滋病毒阳性者死亡的主要原因，因为与世界各地的艾滋病毒阴性癌症相比，诊断出艾滋病毒相关恶性肿瘤（HIVAM）后的生存率更低。在艾滋病毒和病毒致癌基因流行率高的地区，艾滋病定义的恶性肿瘤，如卡波西肉瘤、非霍奇金淋巴瘤和宫颈癌，对艾滋病毒感染者的健康构成了最大的威胁;非艾滋病定义的癌症，如肝细胞癌、肺癌和肛门癌，目前占艾滋病毒感染者的50%以上。在资源有限的情况下，需要制定新的艾滋病毒感染者癌症预防和治疗战略。自2004年以来，弗雷德哈钦森癌症研究中心（FHCRC）与乌干达坎帕拉的乌干达癌症研究所（UCI）合作，开展艾滋病毒感染者和艾滋病患者的研究，并制定新的癌症治疗和预防策略。通过几个完善的培训赠款和与我们的学术合作伙伴，华盛顿大学（UW）和Makerere大学（MU）的牢固关系，我们已经培训了超过250人在艾滋病毒研究和各级护理。与乌干达学术界、政府和临床领导人进行的关键线人访谈发现，在进行艾滋病毒/艾滋病相关的研究方面仍然存在一些差距。我们建议通过三个具体目标来提高乌干达在艾滋病毒/艾滋病和疟疾方面的独立研究能力：1）通过授予博士学位，增加乌干达在艾滋病毒/艾滋病和疟疾方面的研究科学家的数量，并在华盛顿大学和密苏里大学之间建立一个混合计划; 2）通过指导和职业发展的结构化计划，建立艾滋病毒/艾滋病和疟疾方面的独立科学研究能力;（3）通过在对研究活动至关重要的领域进行持续的短期培训，保持在乌干达开展艾滋病毒/艾滋病和疟疾研究的能力。培训活动将由一个经验丰富的杰出委员会监督，该委员会代表来自美国的艾滋病毒和肿瘤学研究领导者以及分布在乌干达全国的三所医学院的所有院长，并将进行严格的衡量和评估。到五年奖励期结束时，将有超过130人在乌干达接受HIVAM研究培训，从而能够开展各种HIVAM研究项目。

DESCRIPTION (provided by applicant): 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 >250 individuals in HIVAM research and care at all levels. Key informant interviews with academic, governmental and clinical leaders in Uganda find that a few gaps in the capacity to conduct HIVAM research persist. We propose to increase the capacity for independent research in HIVAM in Uganda through three Specific Aims: 1) Increase the number of Ugandan research scientists in HIVAM through the conferral of doctoral degrees with an established hybrid program between UW and MU; 2) Build the capacity for independent scientific research in HIVAM through a structured program of mentoring and career development; 3) Maintain capacity to implement HIVAM research in Uganda through ongoing short-term trainings in areas fundamental to research operations. The training activities will be overseen by an experienced and outstanding committee representing leaders in HIV and oncology research from the US and all Deans from three medical schools distributed across the country of Uganda, and will be rigorously measured and evaluated. By the completion of the five-year award period, >130 individuals will be trained in HIVAM research in Uganda, allowing for the conduct of a wide variety of research projects in HIVAM.