The GHESKIO Centers for Research in Haiti: An Education and Research Model in Action

GHESKIO (Groupe Haitien d’Etude du Sarcome de Kaposi et des Infections Opportunistes/The Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections) Centers, founded in 1982, is one of the oldest institutions dedicated to the fight against HIV/AIDS. GHESKIO has 3 main objectives: patient care, training of medical personnel and community leaders, and operational research. GHESKIO efforts are focused on 4 of the most important diseases in Haiti: diarrheal diseases, HIV/AIDS, other sexually transmitted infections (STIs), and tuberculosis (TB). The emphasis is on the family because the diseases that the GHESKIO Centers are concerned with are likely to be spread in the family setting. From its inception, GHESKIO Centers have been affiliated with Cornell University Weill Cornell Medical College and the Haitian Ministry of Public Health and Population (MOPHP). GHESKIO is an official nongovernmental organization recognized by the Haitian government and working in close collaboration with the Haitian MOPHP, which has provided GHESKIO with facilities at the university hospital and at the National Institute Research Laboratory. GHESKIO is the country’s referral center and the Caribbean-leading institution for treatment and research in HIV/AIDS, STIs, TB, and diarrheal diseases. In the 36 years since its inception, the GHESKIO Centers have continued to evolve and grow despite the challenging sociopolitical and economic conditions of the country. Haiti is the poorest nation in the western hemisphere, with 80% of the population living under the poverty line and 54% in abject poverty.1–3 Haiti has the most significant HIV and TB epidemics outside of Africa. In addition, in the past 6 years, Haiti has weathered 3 of the most devastating natural catastrophes in recent times, including a magnitude 7.0 earthquake in 2010, the largest and deadliest cholera epidemic that same year, and a devastating category-5 hurricane, Matthew, in 2016. The GHESKIO model offers integrated preventive and curative services for HIV, TB, STIs, and diarrheal diseases in 2 campuses located in the north and south of Port-au-Prince. This approach has been expanded to include other notable diseases and services. All services are offered at each site to facilitate access to comprehensive care in a “one-stop shop” approach because the poor often cannot afford to travel to different health facilities for all their families’ needs. In addition to health services for HIV/AIDS, including the provision of antiretroviral therapy, treatment for STIs, TB treatment, psychological care, and reproductive health, support is provided with microcredit opportunities, primary and vocational school scholarships, and community outreach interventions that complete the global health model of GHESKIO. The story of GHESKIO is a model of success despite adversity, addressing significant public health problems and making a difference locally and internationally.

Co-infection EBV/KSHV

Le virus herpétique humain associé au sarcome de Kaposi (KSHV) est l’agent étiologique du lymphome primitif des séreuses (PEL) dans lequel le virus d’Epstein-Barr (EBV) est aussi très souvent présent. Jusqu’à présent, seuls des modèles cellulaires permettaient d’explorer l’interaction des deux virus conduisant à la transformation des cellules. Un modèle de co-infection de souris humanisées, développé récemment permet désormais d’explorer ce phénomène in vivo. Il démontre que la co-infection par EBV et par KSHV augmente la persistance de KSHV et favorise la transformation cellulaire via la stimulation de la réplication de l’EBV par KSHV. Il s’agit du premier modèle de PEL chez le petit animal. Cette avancée ouvre ainsi des perspectives intéressantes pour de futures études de ce lymphome.