The University of Washington International AIDS Research and Training Program was initiated in 1985 and has focused on multidisciplinary research on HIV-1 epidemiology and prevention, with Kenya being the primary target country. Over the past 12 years,66 training appointments have been provided for Kenyan scientists to receive research training in Seattle and 24 appointments have been provided for US investigators to receive field research experience in Kenya. A significant body of research has been conducted by IARTP scholars and the Kenya HIV/STD Research Project has emerged as a center for excellence in HIV-1 research. With the current supplement application, we hope to foster the development of a Kenyan center for excellence in HHV-8 research. HHV-8 is a very prevalent infectious disease in many parts of sub- Saharan Africa, with seroprevalence rates of approximately 50% in general adult population surveys. Kaposi's sarcoma incidence has increased >10 fold in conjunction with the HIV-1 epidemic, and is now the leading malignancy in adults and children in some countries. Despite the widespread nature of HHV-8 and the associated burden of malignancy, little is known about the epidemiology of the virus, including modes of transmission. We recently initiated pilot studies of HHV-8 within our PAVE/HIVNET prospective cohort study of prostitutes in Mombasa. We found the HHV- 5 seroprevalence to be 66%, seroincidence to be 2.1% per year, and correlates of infection to include several indices of high-risk sexual behavior. To further address the issue of heterosexual transmission of HHV-8, we developed a proposal to determine HHV-8 seroprevalence, seroincidence, correlates of infection, characteristics of a seroconversion illness, and frequency of viral detection in various compartments including cervical, vaginal, and salivary samples. This research project will form the basis of our HHV-8 research training plan. Three candidates with an interest in acquiring expertise in HHV-8 have been identified. Bhavna Chohan, MS, the laboratory technologist supervisor of the HIV/STD Research Laboratory in Mombasa, will come to the UW for laboratory training in HHV-8 diagnostic methods for 2 months in 2000 as part of an Advanced In-Country Scholar program, followed by PhD training in the Department of Microbiology in 2001. George Ogweno, MD, the physician who has been responsible for the clinical conduct of the prostitute cohort study for the past 2 years, will come to the UW for 1-2 months this summer to attend the Principles of STD/HIV Research intensive course and receive introductory training in biostatistics, after which he will return in 2001 for an MPH degree course in the Department of Epidemiology. Melanie Taylor, MD, an infectious disease fellow at the UW, will go to Mombasa in September for a one year period to gain field research experience with the HHV-8 prostitute study. Drs. Joan Kreiss, Lawrence Corey, Rhoda Ashley, Ludo Lavreys, Barbra Richardson, and Kishorchandra Mandaliya will be key faculty members involved with training in HHV-8 research. The goal of this supplement application is to improve our understanding of HHV-8 epidemiology to enable the development of rational interventions to prevent transmission, and to foster the development of a center for excellence in HHV-8 research in Kenya through research training and infrastructure strengthening.
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