PROJECT SUMMARY/ABSTRACT – UGANDA CORE C The RUSTBELT CFAR Uganda Core C reached several impressive milestones: (i) The core was selected in 2017 as one of 2 lead National HIV drug resistance testing labs for genotyping second-line ART treatment failures. (ii) We added next gen sequencing (NGS) to traditional Sanger-based sequencing for HIV drug resistance testing. (iii) We achieved College of American Pathologists’ (CAP) accreditation in 2017 (recertified in 2019) for HIV drug resistance testing. (iv) The EDITS assay to measure the HIV RNA reservoir was transferred from CWRU. (v) Core C advanced HIV Cure, HIV-TB, HIV-associated malignancies, and cardiovascular complication projects. (vi) Core C became a training and project site for Makerere University (MU) graduate students. The research collaboration between MU and CWRU celebrated its 30th year in 2018 and is widely recognized as a model for successful international cooperation and progress. Currently over 200 Ugandan scientists and health care professionals are engaged in CFAR collaborative programs at the Joint Clinical Research Centre (JCRC), MU, and Mulago Hospital in Kampala. Due to CFAR investments, cutting edge molecular HIV virology and clinical immunology research in Uganda became possible. The integration of the University of Pittsburgh (Pitt) and CWRU/UHMC to form the RUSTBELT CFAR significantly expands Core C’s research and training opportunities for Ugandan, CWRU, and Pitt trainees and researchers by including a broader scope of translational, clinical, and implementation research. Based on these milestones, Core C’s aims are (1) Provide virologic and immunologic research support for studies on HIV complications and the role of gender on HIV infection in Uganda. Core C will incorporate new innovative techniques and assays to study the role of gender in HIV infection and its complications in the following studies: the impact of hormonal status and contraception on the size of the HIV reservoir, the role of gender in HIV co-infection, cardiovascular complications of HIV, HIV associated malignancies, and the microbiome in HIV patients. (2) Expand research on the impact of HIV drug resistance on HIV prevention in Uganda. The collaboration with the team at Pitt brings on board a wealth of expertise which will strengthen Core C in HIV drug resistance and HIV prevention research in Uganda. (3) Provide support for new Translational HIV Research in Uganda for RUSTBELT CFAR investigators. Core C will build on the clinical research experience in Uganda by CWRU’s TB Research Unit and the AIDS Clinical Trials Unit. (4) Continue to provide biomedical training for Ugandan Master and PhD students. Core C through Fogarty D43-010319 "Microbiology and Immunology Training for HIV and HIV-Related Research in Uganda” (MITHU (Boom, Karn, & Joloba, Co-PI). Integration of Pitt with the CWRU/UHMC CFAR to form the RUSTBELT CFAR significantly expands Core C’s research and training opportunities in Uganda. Dr...