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Hepatocellular carcinoma (HCC) is one of the few cancers with increasing incidence in the US attributed largely to prior hepatitis B or C virus (HBV, HCV) infection. Obesity, alcohol, and tobacco exposure also contribute to the growing HCC burden. With improved survival following effective antiretroviral therapy (ART), liver disease including HCC has become a leading cause of death among HIV-infected persons in Western cohorts, mostly affecting those co-infected with HBV or HCV. The recent scale-up of ART among HIV-infected populations in sub-Saharan Africa has translated into dramatic survival benefit. Paradoxically, as HIV-infected persons survive longer, the burden of HCC is expected to increase substantially among aging African populations with endemic HBV, sporadic HCV, and generalized HIV infection. In prior collaborations in Uganda, Drs. Kirk, Ocama and colleagues have documented increasing HCC incidence rates, a high prevalence of liver fibrosis associated with HIV, and demonstrated the feasibility of conducting high-level research on HIV and HCC. Building on existing collaboration between Johns Hopkins and the Makerere University, Uganda Cancer Institute (UCI), Infectious Disease Institute (IDI) and NIAID’s International Center for Excellence in Research (ICER) in Uganda, we propose creation of a partnership focused on HIV and HCC in Uganda: The H2U Consortium

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