Building Capacity for Patient Oriented Research in HIV-associated Kaposi Sarcoma

描述(申请人提供)：卡波西肉瘤(KS)和非霍奇金淋巴瘤(NHL)是在艾滋病毒感染不受控制的情况下发病率显著增加以及高发病率和高死亡率的恶性肿瘤。在受艾滋病毒影响的低收入和中等收入国家，艾滋病毒相关恶性肿瘤的发病率有所上升，夸祖鲁-纳塔尔(KZN)是全球艾滋病毒/艾滋病流行的中心。初步数据表明，该省这两种恶性肿瘤的疾病负担很大。此外，KZN的艾滋病毒相关恶性肿瘤的管理因合并结核病(TB)的沉重负担而变得复杂。迫切需要研究在资源有限的情况下改进这些与艾滋病毒相关的恶性肿瘤的预防和治疗战略。这笔培训赠款的目的是进一步发展研究能力，以便在艾滋病毒相关恶性肿瘤领域以病人为导向的临床研究和以公共卫生为导向的流行病学研究方面促进平行的专门知识。为了实现这些目标，我们将培训一名以流行病学为重点的博士后实习生和一名以临床研究为重点的博士后实习生，在流行病学和生物统计学方法方面进行必要的培训，以发展当地设计和分析以患者为中心的研究的能力。我们还将培训一名博士前学生，学习卡波西肉瘤疱疹病毒(KSHV)和艾滋病毒病毒学实验室方法，以发展当地在生物标记物研究方面的专业知识，目标是将这些专业知识应用于临床和流行病学研究。培训将包括哥伦比亚大学和夸祖鲁-纳塔尔大学(UKZN)的课程作业，哥伦比亚大学教职员工在UKZN教授的单元课程，以及结构化的指导。此外，我们将为初级保健提供者试行两个讲习班，目的是在南非黑人中增加艾滋病毒相关KS的早期检测。通过这笔培训赠款，我们希望扩大研究人员的核心，他们能够在资源有限的情况下研究预防、早期发现和改进艾滋病毒相关KS和NHL的治疗。公共卫生相关性：在受艾滋病毒影响的低收入和中等收入国家，与艾滋病毒相关的恶性肿瘤发病率有所上升，KZN是全球艾滋病毒/艾滋病流行的中心。KZN的艾滋病毒相关KS和NHL的发病率和死亡率很高，迫切需要研究在资源有限的情况下改进这些艾滋病毒相关恶性肿瘤的预防和治疗策略。

DESCRIPTION (provided by applicant): Kaposi sarcoma (KS) and non-Hodgkin's lymphoma (NHL) are malignancies with markedly increased incidence as well as high morbidity and mortality in the setting of uncontrolled HIV infection. Rates of HIV associated malignancies have increased in low- and middle- income countries affected by the HIV, and KwaZulu-Natal (KZN) is the epicenter of the global HIV/AIDS epidemic. Preliminary data suggest a large burden of disease for these two malignancies in the province. Furthermore, management of HIV-associated malignancies in KZN is complicated by the heavy burden of co-morbid tuberculosis (TB). Research towards improved prevention and treatment strategies for these HIV-associated malignancies in resource-limited settings is urgently needed. The objectives of this training grant are to further develop research capacity so as to advance parallel expertise in both patient-oriented clinical research and public-health oriented epidemiologic studies in the field of HIV-associated malignancies. Towards these objectives, we will train one postdoctoral trainee with an epidemiology focus and one postdoctoral trainee with a clinical research focus in the epidemiology and biostatistics methodologies necessary to develop the local capacity to design and analyze patient-oriented studies. We will also train one predoctoral student in Kaposi sarcoma herpes virus (KSHV) and HIV virologic laboratory methods appropriate for developing local expertise in biomarker studies, with the goal of applying this expertise in both clinical and epidemiologic research. Training will consist of coursework at Columbia University and University of KwaZulu-Natal (UKZN), modular sessions taught by Columbia University faculty at UKZN, and structured mentorship. Furthermore, we will pilot two workshops for primary care providers with the goal of increasing early detection of HIV-associated KS in Black South Africans. Through this training grant, we hope to expand a core of researchers capable of studies in the prevention, early detection and improved treatment of HIV-associated KS and NHL in resource-limited settings. PUBLIC HEALTH RELEVANCE: Rates of HIV-associated malignancies have increased in low- and middle- income countries affected by the HIV, and KZN is the epicenter of the global HIV/AIDS epidemic. Morbidity and mortality from HIV-associated KS and NHL in KZN is high, and research towards improved prevention and treatment strategies for these HIV-associated malignancies in resource-limited settings is urgently needed.