"Plasma and cellular immune biomarkers of Kaposi's sarcoma in HIV-1 suppressed patients"

“HIV-1 抑制患者中卡波西肉瘤的血浆和细胞免疫生物标志物”

基本信息

批准号：
10871931
负责人：
Salum Juma Lidenge
金额：
$ 10万
依托单位：
MUHIMBILI UNIVERSITY/ ALLIED HLTH SCIS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10871931
关键词：
Acceleration Acquired Immunodeficiency Syndrome Address Africa Africa South of the Sahara Age Age Years Aging Area Attention Biological Markers Biometry Cancer Patient Caring Cessation of life Child Chronic Chronology Clinical Clinical Research Coupled Data Data Analyses Data Set Development Diagnosis Disease Educational workshop Elderly Electronics Ethics Female Fostering Future Gender Generations Grant HIV HIV Infections HIV Seropositivity HIV-1 HIV/AIDS Health Immunologic Markers Incidence Inequality Inflammation Infrastructure Instruction Interdisciplinary Study Kaposi Sarcoma Life Expectancy Longevity Malignant Neoplasms Manuscripts Mentors Mothers Nature Oceans Outcome Output Parents Patient Care Patients Persons Plasma Population Preparation Prevalence Process Productivity Professional Competence Research Research Design Research Personnel Research Priority Research Training Sample Size Tanzania Time Training United States National Institutes of Health age related aging population antiretroviral therapy cancer diagnosis career co-infection cohort comorbidity data curation demographics design disorder control diversity and inclusion hands on research improved mortality pandemic disease recruit response scale up skill acquisition skills sociodemographics tool training opportunity trend

项目摘要

PROJECT SUMMARY/ABSTRACT Successful ART coverage has has reduced AIDS-related mortality from 2.2 million in mid 2000s to 1.8 million in 2019. In turn, this has led to global increase in life expectancy of PLWH. In the US, it is estimated that 50% of the PLWH are older than 50 years and accounts for 70% of total deaths among PLWH. The ageing population of PLWH is now facing an increase in age-related non-communicable diseases like cancers. However, in sub-Saharan Africa (SSA) where ~66% of global 38.4 million PLWH reside, data on the changing demographics of the HIV pandemic are scarce. Although it is expected that non-HIV- associated malignancies (HIVAM) to increase and at an earlier age at diagnosis as a consequence of ageing among PLWH, there is limited data on the impact of HIV and ageing on cancer development in SSA. The limited data on the impact of ageing on health and the nature of the accelerated ageing process in PLWH in SSA could be partly due to the fact that, 1) prior to ART scale up in Africa, most PLWH were not treated with ART and died at an earlier age, rarely lived beyond 50 years of age. It is only through ART a new generation of PLWH are now ageing in SSA. 2) Importantly, in the past, most of the training opportunities in SSA focused on the training of clinicians to address patient care with minimal emphasis on research training. Coupled with limited research training opportunities, particularly in HIV and ageing, this has led to low research output in SSA. To address this gap of well-trained HIV researchers, we are proposing to recruit and mentor an early-stage female investigator (Dr. Herrieth) on the basics of HIV research through academic instruction and conducting a hands-on research training to determine the incidence, trends, and outcome of non-HIVAM in ageing PLWH in Tanzania. The overall objective is to train the already identified young, enthusiastic female early-stage investigator on expansion of the K43 dataset to include other cancers in order to determine incidence, trends, and outcomes of non-HIVAM in Tanzania. We hypothesize that while successful ART improves lifespan of PLWH, but it also lead to an increase in incidence of non-HIVAM, at an earlier chronological age at cancer diagnosis due to HIV associated chronic inflammation and unwanted effects of ART. We will utilize the parent K43 study infrastructure to integrate, and train the early-stage investigator on how to a) design tools for secondary data curation, and b) perform data analysis to determine incidence, trend, and outcome of non-HIVAM among ageing PLWH. This training is significant as it provides a unique opportunity for the trainee to acquire skills in HIV and ageing research. Moreover, the study will foster gender inclusion and diversity in research, motivate others, and improve the multidisciplinary research workforce. Overall, these efforts will generate preliminary data for future studies to understand the impact of HIV and ageing to improve health outcomes for PLWH in SSA.

项目概要/摘要成功的抗逆转录病毒治疗已将艾滋病相关死亡率从 2000 年代中期的 220 万人减少到 1.8 人 2019 年将增加 100 万。反过来，这又导致全球艾滋病病毒感染者的预期寿命延长。在美国，估计 50%的感染者年龄超过50岁，占感染者死亡总数的70%。这 PLWH 人口老龄化现在面临着与年龄相关的非传染性疾病增加的问题，例如癌症。然而，全球 3840 万艾滋病感染者中约有 66% 居住在撒哈拉以南非洲 (SSA)，数据显示，艾滋病毒大流行的人口统计数据变化很少。尽管预计非 HIV- 相关恶性肿瘤（HIVAM）增加，且诊断时年龄较早，原因是在 PLWH 中，关于艾滋病毒和老龄化对癌症发展的影响的数据有限。 SSA。关于衰老对健康的影响以及加速衰老过程的本质的数据有限撒哈拉以南非洲地区的 PLWH 中出现这种情况的部分原因可能是：1) 在非洲扩大抗逆转录病毒治疗之前，大多数 PLWH 都是未接受 ART 治疗且较早死亡，很少活过 50 岁。只能通过艺术 SSA 的新一代感染者和艾滋病患者现在正在老龄化。 2）重要的是，过去大部分训练 SSA 的机会侧重于培训临床医生以解决患者护理问题，而很少强调研究培训。再加上有限的研究培训机会，特别是在艾滋病毒和老龄化方面，这导致 SSA 的研究成果较低。为了解决训练有素的艾滋病毒研究人员的缺口，我们正在提议招募一名早期女性调查员（赫里思博士）并为其提供有关艾滋病毒基础知识的指导通过学术指导和进行实践研究培训来确定研究坦桑尼亚老年 PLWH 中非 HIVAM 的发生率、趋势和结果。总体目标是训练已确定的年轻、热情的女性早期研究员，致力于扩展 K43 数据集包括其他癌症，以确定坦桑尼亚非 HIVAM 的发病率、趋势和结果。我们假设，虽然成功的 ART 可以延长 PLWH 的寿命，但它也会导致由于 HIV 相关慢性病而导致癌症诊断时较早的非 HIVAM 发病率炎症和 ART 的不良影响。我们将利用母公司 K43 学习基础设施来整合，并培训早期研究者如何 a) 设计二次数据管理工具，以及 b) 执行数据分析以确定老年 PLWH 中非 HIVAM 的发生率、趋势和结果。这培训非常重要，因为它为受训者提供了获得艾滋病毒和老龄化技能的独特机会研究。此外，该研究将促进研究中的性别包容性和多样性，激励他人，并提高多学科研究队伍。总体而言，这些努力将为以下方面产生初步数据：未来的研究旨在了解艾滋病毒和老龄化的影响，以改善撒哈拉以南非洲地区艾滋病毒感染者的健康状况。