HIV Infection and AIDS in Uganda

Robbins, Frederick

Abstract

The Ministry of Health of the Republic of Uganda, Makerere University, and Case Western Reserve University jointly are submitting this application for International Collaboration in AIDS Research. This program applies the complementary expertise of U.S. and Ugandan investigators in the fields of anthropology, epidemiology, microbiology, molecular biology, pathology, immunology, virology, international health, clinical infectious diseases, oncology, and pediatrics to the study of AIDS. The central research objective of this proposal is to examine the role of endemic infectious agents and exposures and behavioral practices in the transmission and expression of HIV infection in Uganda. Project 1 studies transmission and course of HIV infection in infants. In this prospective study, the influence of maternal, perinatal and postnatal factors on the transmission of HIV infection and progression to disease will be examined. The clinical, neurodevelopmental and immunologic manifestations of AIDS in infants also will be defined. Project 2 examines prevention, serodiagnosis and course of tuberculosis in HIV- infected patients. Mycobacterial species which cause disease in HIV- infected persons will be identified:; prospective studies will evaluate immunologic function as a predictor of outcome of tuberculosis; the protective efficacy and safety of vaccination with BGC; and the value of serodiagnosis as a rapid diagnostic approach. Project 3 evaluates the role of lymphotrophic viruses in Kaposi's sarcoma and non-Hodgkin;s lymphomas with HIV infection and the possible roles of other lymphotrophic viruses as co-factors in their development. Project 4 evaluates family structure and social organization of risk behaviors. Possible association of HIV infection with cancer of the cervix and penis also will be explored. Anthropologic techniques will examine the interrelationships between family structure and HIV infection; polygynous marital unions and behavioral practices will be assessed as risk factors for HIV infection and the impact of the diagnosis of AIDS on family organization, function, stability, understanding of AIDS and behavior will be determined. These studies will be supported by an Administrative and Data Management Core and a Virology and Molecular Biology Core. The Program will provide information about Aids of value to Uganda in its efforts to control the disease and to the U.S. as the disease spectrum shifts into heterosexual and pediatric populations.