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.

Public Health Relevance

Cancer is a leading cause of disability and death among HIV infected persons worldwide, and overall incidence of cancer in patients with HIV has increased annually since the widespread use of antiretroviral therapy. Through our long-standing collaboration between the Uganda Cancer Institute and the Fred Hutchinson Cancer Research Center, we will train African research leaders to identify new strategies to prevent, diagnose, and treat HIV-associated malignancies in Uganda and other countries in sub-Saharan Africa.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
International Research Training Grants (D43)
Project #
2D43TW009759-06
Application #
9769553
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Bansal, Geetha Parthasarathy
Project Start
2014-06-01
Project End
2024-03-31
Budget Start
2019-04-30
Budget End
2020-03-31
Support Year
6
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Fred Hutchinson Cancer Research Center
Department
Type
DUNS #
078200995
City
Seattle
State
WA
Country
United States
Zip Code
98109
Menon, Manoj P; Coghill, Anna; Mutyaba, Innocent O et al. (2018) Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute. J Glob Oncol :1-9
Bender Ignacio, Rachel; Ghadrshenas, Matine; Low, Daniel et al. (2018) HIV Status and Associated Clinical Characteristics Among Adult Patients With Cancer at the Uganda Cancer Institute. J Glob Oncol :1-10
Phipps, Warren; Kansiime, Rachel; Stevenson, Philip et al. (2018) Peer Mentoring at the Uganda Cancer Institute: A Novel Model for Career Development of Clinician-Scientists in Resource-Limited Settings. J Glob Oncol :1-11
Okuku, Fred; Krantz, Elizabeth M; Kafeero, James et al. (2017) Evaluation of a Predictive Staging Model for HIV-Associated Kaposi Sarcoma in Uganda. J Acquir Immune Defic Syndr 74:548-554