# Improving the Accuracy of Diagnosis of Cancer in Children with HIV Infection

> **NIH NIH U54** · BAYLOR COLLEGE OF MEDICINE · 2020 · $135,541

## Abstract

Project 2: Improving the Accuracy of Diagnosis of Cancer in Children with HIV Infection
The goal of Project 2 is to evaluate and implement novel strategies that are reproducible and sustainable
across treatment sites in sub-Saharan Africa (SSA) to improve real-time diagnosis of HIV-associated pediatric
cancers, because this is a prerequisite for evidence-based treatment and clinical/translational research.
Diagnosis of cancer in children in SSA is a major challenge because of scarcity of local skilled personnel,
facilities for obtaining tissue biopsies, and laboratory platforms for pathology analysis. The result is that for
many children with suspected cancer a diagnosis is made based on clinical features only. If a biopsy is
obtained, morphological examination using Hematoxylin & Eosin (H&E) stain is often the only test performed.
In our study of 324 with HIV infection and diagnosed with KS at BIPAI centers in Uganda, Malawi, Tanzania
and Botswana from 2008 – 2014, 141 (43%) of the children were diagnosed based on clinical history and
examination only. The overarching aim of this project is to implement and evaluate harmonized diagnostic
strategies in PARCA sites.
Aim 1: Evaluate the adequacy of biopsies and diagnostic accuracy of the current Global HOPE Uganda
diagnostic strategy for pediatric cancer tumors. We will retrospectively assess the proportion of adequate
biopsies, and repeat or escalation to open surgical biopsy among 400 children with HIV-associated cancers.
To determine the accuracy of the current diagnostic strategy, we will perform gold-standard diagnostic assays
by United States standards on archived FFPE tissues from these 400 cases.
Aim 2: Determine the feasibility of standardizing the diagnostic algorithm across multiple sites by
implementing a similar algorithm in Malawi. We will implement a similar diagnostic approach in Malawi by
training medical personnel to use a similar biopsy strategy and expanding the flow cytometry and IHC antibody
panels to mimic those performed in Uganda. To ensure accuracy and consistency across sites in preparation
for implementation of standardized cancer treatment and research protocols across SSA sites, we will
implement a virtual pathology platform to enable sharing and central review of images. The virtual pathology
network will also serve as a platform for ongoing training of pediatric pathologists and technicians.
Aim 3: Improve accuracy of cancer diagnosis at SSA sites by designing, testing, and implementing
novel diagnostic methods. We will test and validate novel molecular assays of established diagnostic
biomarkers to improve timeliness and specificity of the diagnosis using platforms and procedures that are
sustainable in the SSA setting. Consideration will be given to cost, complexity, and turnaround time.

## Key facts

- **NIH application ID:** 10084677
- **Project number:** 1U54CA254569-01
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Julie M Gastier-Foster
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $135,541
- **Award type:** 1
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10084677

## Citation

> US National Institutes of Health, RePORTER application 10084677, Improving the Accuracy of Diagnosis of Cancer in Children with HIV Infection (1U54CA254569-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10084677. Licensed CC0.

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