HIV CO-INFECTIONS IN UGANDA

Infectious Diseases Institute, Kampala

Investigators

Linked publications & trials

Abstract

Increasing availability of antiretroviral therapy (ART) in sub-Saharan Africa (SSA) has led to decreases in mortality rates. The WHO estimates that 940,000 million deaths were attributable to HIV in 2017, with the majority caused by co-infecting pathogens. Uganda still has a prevalence rate of 6.5% among adults aged 15-49 (UNAIDS). Many patients still present late and often co-infected with opportunistic infections such as tuberculosis (TB) and cryptococcal meningitis. Viral hepatitis (B & C) co-infection occurs in 2-10% and poses challenges in terms of best anti-viral treatment, diagnosis, and prevention. Challenges present also for HIV-infected individuals stable on ART, because they are at higher risk of “non AIDS” non-communicable diseases, particularly hypertension, diabetes mellitus, renal disease, pulmonary disease, cardiovascular disease, cancer, bone abnormalities and liver failure. HIV infection itself also seems to be associated to an accelerated aging process. The Infectious Diseases Institute (IDI) in Uganda is a Research and Care Center of Excellence and has already established research programs in HIV and co-infections under the previous Heads of Research (Y. Manabe, and A Kambugu, previous Program Director and Uganda Program Director respectively). The current Head of Research (B Castelnuovo- proposed Program Director in this Cycle), has worked closely with Dr Manabe and Dr Kambugu for the last 10 years, when she was the Head of the Research Capacity Building Unit and Deputy Head of Research. We plan to train 9 master students, 2 PhD students and 5 post-doctoral students at Makerere University, Uganda. Our previous 5-year cycle has solidified a core group of productive, independent scientists through post-doctoral training who can now act as local mentors. We will shift the leadership of the training program from the US to the Uganda Institution in order to ensure sustainable research capacity building. We will also encourage a peer-to-peer mentorship model among scientists with the same level of experience to expand the impact of training. International mentors will still play a key role in overall mentorship of the local experts particularly to expand research networks and to provide grant-writing support. At the end of this 5-year training program, our overarching objective is to solidify a core group of expert, productive, independent scientists who can promote sustainable capacity building by garnering outside funding, continuing to mentor others including peers, and be recognized as international, regional leaders and mentors in the area of HIV co-infections.