Category: Department of Infectious Disease

The one with a Nobel prize winner

Hadi Sallah, PhD student in John Tregoning's lab, working on RNA vaccines.
Hadi Sallah, PhD student in John Tregoning’s lab, working on RNA vaccines.

Dr John Tregoning, Professor in Vaccine Immunology, recounts his experience of working with Dr Katalin Karikó, Nobel Prize winner and the tenacious force behind the mRNA vaccines that helped change the course of the COVID-19 pandemic. Their recently published study investigates how RNA modifications impact the body’s immune response to infection, with the hopes of aiding the development of more effective mRNA vaccines.

Science is collaborative, we work with lots of different people to understand the world around us. Working with other people is one of the joys of the job. In our recently published study, Reducing cell intrinsic immunity to mRNA vaccine alters adaptive immune responses in mice, we had the privilege of working with Dr Katalin Karikó, joint winner of the 2023 Nobel prize in Physiology or Medicine.

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Why not eliminate HTLV-1 while eliminating HIV-1? We need HTLV-1 PEP/PrEP clinical trials.

Dr Goedele Maertens and Dr Fabiola Martin

HTLV-1 PrEP Open Letter to Gilead & ViiV 

Human T Lymphotropic/Leukaemia Virus-1 (HTLV-1) is a sexually transmitted infection (STI) closely related to human immunodeficiency virus-1 (HIV-1). HTLV-1 causes chronic infection, can be transmitted from mother to baby and is associated with significant disease burden and mortality, preceded by years of suffering and poor quality of life for victims.   

Therefore, HTLV-1 is one of the 2030 elimination targets of the World Health Organization’s global STI elimination strategy.  

Although there is currently no drug or vaccine available to cure HTLV-1, we now know that the very same drugs that effectively treat patients with HIV or prevent people from getting HIV-1, called HIV PrEP, also prevent the transmission of HTLV-1 in our laboratory testing (Reviewed in Bradshaw and Taylor, Frontiers in Medicine 2022). We believe that these compounds are likely to block the transmission from mother to child. 

It is well known that many HIV PrEP clinical trials are conducted in countries where HTLV-1 is common. So, by adding in HTLV-1 testing to these HIV-PrEP trials we could measure if the HIV PrEP drugs also prevent HTLV-1 transmission. The beauty of such an outcome would be that these HIV-1 drugs are already licensed to be used in humans.  

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Embracing doubt in science

Nana-Marie Lemm, Clinical Research Fellow

Why is ‘doubt’ an important resource in science? How can we support the kind of science that takes intellectual risks – and takes time? Nana-Marie Lemm, Clinical Research Fellow at the Department of Infectious Disease, gives her reflections on the recent Day of Doubt conference, organised by the Good Science Project. 

What are the motivations for becoming a scientist? It might be the search for truth or to understand how things work, or to work towards a greater good. But how does that idea compare to the reality of the day-to day work of science, and the culture of doing science? 

The Day of Doubt was the first conference of its kind at Imperial College London. Organised by The Good Science Project, the conference aimed to reflect on research culture at the university level and beyond. It provided a space for discussion, reflection, and the opportunity to ask fundamental questions.  

So, what is ‘doubt’ and why might it be important in science? The team behind the Good Science Project have helpfully created a thesaurus of doubt and a memo document on the day. In the latter, Dr Anthea Lacchia writes:  

“If we take doubt to be the opposite of complacency, it is associated with pause, with thoughtful hesitation. Yet, this act of questioning, of taking necessary time before making a decision, seems at odds with the push for success, publications, and the need for high impact results. In truth, science is full of conflicts, some internal, some relating to wider culture.”  

On the day, there was the opportunity to take time to engage in the act of questioning. Reflective sessions ranged from questioning concepts such as, ‘public engagement,’ ‘interdisciplinarity,’ ‘excellence,’ ‘expertise,’ to delving into philosophical discussions surrounding the nature of scientific truth. 

A key question to speakers in the first session of the conference that resonated with me was,  “How do you talk about doubt when you don’t come from a position of seniority and confidence?” 

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“Why am I depressed, doc?” Experiences of an HIV clinician and researcher

HIV Stop Stigma

Despite major progress in treatment and prevention, being diagnosed with HIV can have a big emotional impact on individuals. People with HIV have higher rates of mental health problems than those seen in the general population. One reason for this may be HIV-related stigma, explains Professor Alan Winston from the Department of Infectious Disease. 

Since the late 1990s, I have been treating people living with HIV and been involved in HIV clinical research. Many things we read about HIV are success stories, and quite rightly we should celebrate these tremendous scientific and medical advances. Life expectancy for someone with HIV is now similar to that of the general population. Antiretroviral therapy generally has manageable side effects and for most individuals, does not incur that many tablets per day. Indeed, many HIV treatments involve taking only one tablet per day. So, why then do so many people with HIV suffer from depression, other mental health conditions, and a poorer quality of life? 

Experience in clinic 

Most people living with HIV, once on a stable treatment, will attend their treatment centre twice per year. Often appointments rotate between a consultant or medical doctor once per year and a nurse specialist on the other occasion. As we can’t cure HIV, our patients attend for life, and we get to know them very well. At consultations, in addition to routine monitoring, we ask people how they are keeping. What stands out are the number of individuals who report symptoms of depression and other mental health conditions such as anxiety. Whilst many of us suffer from mental health complaints, the burden of these complaints in people living with HIV is very high. Thankfully, we do have help in clinic and have a specific clinic run by a psychiatry nurse specialist we can refer patients to. 

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“Research is very much a team effort and I see this award as a reflection of that.” – Dr Felicity Fitzgerald, 2023 Simon Newell Award winner

Dr Felicity Fitzgerald

Dr Felicity Fitzgerald (who volunteered clinically during the West African Ebola outbreak) has been selected as the winner of the 2023 Simon Newell Award for her work in Zimbabwe to improve recognition and outcomes of newborns with suspected sepsis. Dr Fitzgerald spoke to the Royal College of Paediatrics and Child Health (RCPCH) about her research and tips for aspiring researchers.

The Simon Newell Award Recognises an outstanding young medically qualified researcher in British paediatrics. Each year, with support from GOSH Charity and Sparks, RCPCH offer the prestigious award of £2,000 to one early independent researcher in paediatrics.

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Is an H5N1 ‘bird flu’ pandemic inevitable?

The largest ever outbreak of bird flu is spilling over into mammals, including foxes and otters in the UK. Could this transmission see a jump to humans? Dr Thomas Peacock from the Department of Infectious Disease discusses.

Avian influenza virus has been featured prominently in the news again over the past few months. Headlines urge vaccine stockpiling, show images of beaches covered in dead sea birds or seals, or people in hazmat suits carrying bin bags full of dead birds or mink. Three years into the COVID-19 pandemic, is another pandemic unavoidable?

We have been in this situation before, back in the late 1990s and early 2000s, headlines spoke of ‘bird flu’ – H5N1 viruses ancestral to the ones currently circulating in Europe – as the inevitable coming pandemic. In fact, in 2009 an influenza pandemic did occur, but rather than the deadly H5N1 bird flu, it was caused by an obscure swine influenza virus that passed onto humans and caused the 2009 ‘swine flu’ pandemic.

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World AIDS Day: We have come a very long way but there is still much to do to protect those at risk

Professor Sarah Fidler

This festive period Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

While HIV is no longer the death sentence that it once was, lifelong treatment is still required and there is no cure – yet. Professor Sarah Fidler from the Department of Infectious Disease discusses how a new type of HIV treatment holds promise as a longer-lasting alternative to current complex drug regimens.

Despite extraordinary political and medical advances, HIV, the virus that causes AIDS, remains one of the world’s most serious public health challenges. Since its discovery in 1983 by researchers at the Pasteur Institute in France, 84 million people worldwide are estimated to have become HIV-positive and 40 million people have died from an HIV-related illness. Today, there are around 38 million people living with HIV globally, with 1.5 million new infections in 2021.

Advocacy and close collaboration between clinicians, scientists and the HIV-affected community has inspired and driven the research and drug development and access agenda. Without these close working relationships, the development of HIV treatments would have been markedly slower and many more lives would have been lost.

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Can we save lives by deliberately infecting people?

A person's arm being injected

In the middle of the pandemic, scientists intentionally infected healthy volunteers with SARS-CoV-2, the virus that causes COVID-19. John Tregoning, Reader in Respiratory Infections at the Department of Infectious Disease, explains why these experiments, and the volunteers who take part in them, are critical to modern medicine.

In early March 2021, in the middle of the COVID-19 pandemic, a surprising-sounding set of experiments were taking place. Researchers at Imperial College London (and separately at the University of Oxford) were deliberately infecting healthy volunteers with SARS-CoV-2. This was in fact the latest in a long line of controlled human infection studies – where volunteers are deliberately infected with an infectious pathogen under extremely controlled conditions.

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Could we have a simple solution to this huge HIV problem?

Test tube of blood with a label written "HIV TEST"

There are currently 38 million people infected with HIV worldwide with up to a million deaths each year.  During National HIV Testing Week, we hear from Dr. Catherine Kibirige  who has developed a highly sensitive HIV-1 test that can detect a single infected cell with high precision.

Meet Dr. Fred Nsubuga, he manages the Diagnostics Laboratory at Jinja District Hospital in Uganda.  His laboratory is not equipped for HIV-1 treatment monitoring, so, when patients come in who need a viral load test, he must collect, process and store their blood samples, batch them together, then send them on a truck to the national HIV testing laboratory in Kampala, the capital city, 44 miles away.  Despite the availability of this state-of-the art facility which boasts a Roche Cobas 8800™ high-throughput instrument with a good computer-based laboratory management system, it can take months for the results to get back to him.  Sometimes, they go missing.  

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We need to give everyone, everywhere, the precious gift of health

Professor Faith Osier

This festive period Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

Professor Faith Osier shares her vision for health equity, from tackling vaccine inequity to empowering the next generation of scientists globally.

Almost a year ago to the day, my partner and I woke up our three young children in the middle of the night, readied them for the airport, hurriedly scrambled together the last of our belongings and embarked on a new adventure. We were moving from Heidelberg, a picture-perfect city that often made me feel like I was walking into a tranquil postcard. This had been home for four years and we kept our mixed feelings to ourselves as we ventured into the unknown, London. I was taking up a new position as the Executive Director of IAVI (formerly International AIDS Vaccine Initiative), at Imperial College London. We navigated the intricacies of relocating during lockdown, settled the children into school or rather “joyous home-learning” as was the case at the time, and I began to unpack my new job.

The mission of IAVI resonates strongly within me: “translating science into affordable, globally accessible public health solutions”. The opportunity to turn years of scientific endeavour into interventions that could transform the lives of the most vulnerable on our planet still springs me out of bed every day.  I have worked for over 25 years amongst the rural poor in Kilifi, Kenya, studied immune responses to malaria antigens in samples from similar study participants across Africa and appreciated first-hand the impact of ill-health on productivity, livelihoods and hope. (more…)