Human papilloma virus (HPV) associated malignancies are major public health concerns in Uganda which has among the highest cervical and penile cancer rates in the world. Uganda also has a mature generalized HIV epidemic and HPV/HIV coinfections are common, resulting in increased progression to neoplasia. Hepatitis B virus (HBV) infection and associated hepatocellular carcinoma (HOC) are also of concern inUganda. The Rakai Health Sciences Program (RHSP) in conjunction with collaborators at Makerere University (MU) and Johns Hopkins University (JHU) proposes to train clinicians, scientists and laboratory personnel in the diagnosis, management and prevention of these HIV associated malignancies, building onprior Fogarty supported training, as follows: 1. HPV/HIV associated malignancies: 1.1 Two year ScM in a Interdepartmental Program of Molecular Epidemiology (IPME) at JHU (HPV epidemiology, HPV detection, histopathology and immunohistochemistry with lab rotations, and postdoctoral fellowship in Year 3 for preparation of a GRIP proposal. 1.2. Training of two senior Ugandan lab technicians in HPV detection (Digene Hybrid Capture 2, and Roche Blot PCR) in women at JHU, and detection of penile HPV at the MoffitCancer Center, Tampa. (Digene will donate hybrid capture 2 equipment). 1.3. Pathology and cytopathology training by JHU pathologist in a newly established pathology lab at RHSP. 1.4. Immunohistochemistry training at JHU. 1.5. Clinical training in colposcopy, biopsy and cryotherapy, and liquid-based PAP smear methods in Uganda. 2. HBV/HIV associated malignancies: 2.1. The ScM IPME trainee (1.1. above) will be cross-trained in the epidemiology and assay of HBV/HCV, HCC pathology and clinical diagnosis. 2.2. The 2 laboratory techs (1.2 above) will be cross-trained in HCV/HBV assays and tumor marker detection (alphafetoprotein) at JHU. 2.3 Training of 3 Ugandan pathologists in HCC morphology and immunohistochemistry at JHU and the Armed Forces Institute of Pathology. 2.4. Clinical training for 2 physicians and 2 techs in ultrasound imaging for HCC diagnosis and Fibroscan technology for liver fibrosis at JHU and MU. The proposed training will provide expertise for future Ugandan research on HIV associated malignancies.
Malignancies due to HPV and HBV (cervical, penile abd liver cancer) are major public health problems in Uganda, and are associated with HIV co-infection. In-country limitations of expertise has hampered research on the prevention, diagnosis and management of these HIV co-infections and their neoplastic sequelae. This proposed training program will provide a critical mass of Ugandan investigators to foster future research on these problems. ? ? ?
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