PROJECT SUMMARY The Northwestern/Nigeria Research Training Program in HIV and Malignancies (NN-HAM) addresses a high priority NIH research area and significant problem in sub-Saharan Africa because of the widespread HIV epidemic made worse by the high burden of oncogenic viral co-infections. Antiretroviral therapy programs put into place by PEPFAR, the Global Fund and others, have resulted in a remarkable decrease in HIV-related morbidity and mortality; however, the rate of certain malignancies are rising while the HIV population is aging. Most African medical and research institutions are ill-prepared to confront these emerging challenges. For over 10 years, University of Jos, University of Lagos, and Northwestern University have successfully collaborated on several NIH grants focusing on HIV and HIV-associated conditions including cancer. We also formed a network to successfully complete an NCI-funded U54 (Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria, 1U54CA221205). This renewal Fogarty HIV Research Training Program for LMICs proposal will continue to advance Nigerian scientists’ capacity for large population-based HIV-malignancy and diagnostics research by training scientists focused on cancer molecular epidemiology and clinical investigation. Our primary hypothesis is that building capacity in molecular cancer epidemiology, biostatistics, and clinical investigation on HIV-associated malignancies will significantly enhance our understanding of cancer epidemiology and diagnostics to promote mechanistic biomarker-based research that will inform preventive and therapeutic strategies, ultimately leading to a reduction in cancer incidence and mortality. This renewal application’s specific aims are to: 1. train cancer molecular epidemiologists and clinical investigators capable of: i) designing and conducting population-based molecular epidemiology studies; ii) developing protocols for biospecimen collection, processing, and storage; iii) developing biomarkers that can be used for prevention and improved treatment of HIV-associated malignancies; and iv) translating biomarker assays into novel point- of-care (POC) tests for diagnosis and screening of HIV-associated malignancies; 2. train master’s degree-level scientists in biostatistics, clinical investigation, and epidemiology who can manage and handle data from clinical, laboratory, and population settings, and perform comprehensive clinical validation and epidemiological (population-based) studies; 3. create a multidisciplinary research team, led by Nigerian investigators, capable of performing advanced in-country HIV-associated cancer molecular epidemiology and diagnostics research at University of Jos and University of Lagos. We will achieve our goals through strong leadership, mentorship and research training including: 1 PhD degree and 3 master’s degrees (long-term), 3 medium-term research- project-driven training programs, several short-term in-country workshops, and innovative distance learning.

Narrative Antiretroviral therapy programs put into place by PEPFAR, the Global Fund and others have resulted in a remarkable decrease in HIV-related morbidity and mortality; however, the rate of certain cancers are rising significantly as HIV population are aging. Most sub-Saharan African medical institutions are ill prepared to deal with this emerging health challenge. This Nigerian-led research-training program will build capacity in molecular cancer epidemiology, biostatistics, and clinical investigation to train researchers to conduct population-based molecular epidemiology and diagnostics research, leading to the development of preventative and therapeutic strategies to reduce incidence and decrease mortality of HIV-associated malignancies in Nigeria.