Blog posts

Working with HIV/AIDS patients was the highlight of my clinical career


Originally published on the Imperial College Healthcare NHS Trust blog, Professor Jonathan Weber, Dean of our Faculty of Medicine, shares the story of his career working with people affected by HIV/AIDS.

In April 1982, I was a young doctor with an interest in infectious diseases when my mentor, Professor Philip Marsden, mentioned a new disease he’d seen in New York, which was affecting young gay men and had all the hallmarks of a sexually transmitted infection. He suggested it would be interesting to look for this new disease in London and he thought St Mary’s Hospital might be a good starting point. So in August 1982, I joined Dr Willie Harris’ Praed St Clinic, looking at the immune system of gay men who visited the clinic, guided by immunologist Professor Tony Pinching and virologist Professor Don Jeffries.

Early observations

I was fortunate to be able to work on my research full-time from early 1983, thanks to a fellowship  from the Wellcome Trust; I had gathered a cohort of 400 gay men at the clinic and examined their immune systems. What my colleagues and I discovered was that all the men in the cohort had abnormal immune systems; they all had a low number of CD4+ T-lymphocytes and low CD4:CD8 T-cell ratios. They also had enlarged lymph nodes in their necks, armpits and groin, which is usually a sign that the body is trying to fight an infection. These observations led us to believe that all the patients in this cohort had an early manifestation of AIDS; it was a chilling insight into the scale of the unfolding AIDS epidemic. (more…)

HTLV-1: Time to care, time to take action

HTLV-1

Ahead of the WHO Global Consultation on HTLV-1, Professor Graham Taylor outlines three steps to prioritise the neglected cancer-causing virus.

“I couldn’t do anything for a week after I opened the letter and saw that I was infected with it. I saw H and thought I had HIV. I’d never heard of HTLV”.

It’s not the first time that I’ve heard this, but this was two days ago, almost 40 years since the report in 1980 of the discovery of the human T-cell lymphotropic virus (HTLV-1). Sadly Janet* is joined in her lack of awareness not only by almost the entire general public but also by most healthcare professionals.

This weekend saw World HTLV Day marked for the second year, with the slogan is: ‘It’s time to care’. This is in response to a general perception that there is a widespread indifference toward HTLV. Hopefully this will change soon. This week, I fly to Tokyo to participate in a WHO Global Consultation on HTLV-1 to address the public health impact and implications of this little-known virus. (more…)

How reconstructing the past hepatitis B epidemic can help prevent liver cancer in the future

Nora Schmit was shortlisted for the MRC Max Perutz Science Writing Award 2019 for the following article on her PhD research on predicting the impact of treatment for hepatitis B infection on preventing liver cancer in The Gambia.

What’s the first thing that comes to your mind when you think of cancer prevention? Maybe you’re thinking of not smoking or maintaining a healthy weight – great strategies to reduce your chance of getting cancer.

But did you know that the hepatitis B vaccine, introduced in the 1980s, has long protected children in many parts of the world from developing one of the most common and deadliest cancers later in life?

Although most people have no symptoms when they first become infected, the hepatitis B virus is the leading cause of liver cancer worldwide. Large-scale efforts to tackle the virus using vaccination have been hugely successful in preventing infections in children. Despite this remarkable achievement, hepatitis B infections are still very common and nearly a million people die from its consequences every year. With around 6% of all people living in Africa currently infected, the death toll there is expected to rise even further.

But while a liver cancer diagnosis is nearly always fatal, treating the infection is possible with the same drugs that work against HIV. So why do so few people receive these drugs, when over half of all liver cancer deaths globally are preventable? (more…)

News worth celebrating for the cystic fibrosis community

Professor Jane Davies reflects on the positive news for those affected by cystic fibrosis on both sides of the Atlantic – access to Orkambi on the NHS and FDA Approval of ‘triple combination’ in the US.

Last week marked a milestone for people living with cystic fibrosis (CF) in the UK after NHS England announced that new drugs – Orkambi and Symkevi – will be made available on the NHS after securing a deal with the drug manufacturers, Vertex. After four years of community and patient organisation campaigns, I am delighted with this outcome which will be transformative for young people with CF.

There are over 10,000 people in the UK and over 100,000 worldwide estimated to be living with cystic fibrosis (CF). The condition is caused by a faulty gene encoding for a cell surface ion channel called Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Ion channels are integral for regulating salt and water transport across mucosal surfaces, particularly in the lungs for defence against infections and in the digestive system. People with CF have a shorter life expectancy than healthy people and a hugely burdensome treatment regime just to keep as well as possible. (more…)

What is environmental inequality and why should we care?

Charlotte Roscoe highlights the problem of environmental inequality and explores how potential solutions such as urban green spaces may help to close the gap.

Whether it’s standing on picket lines with Mind the Pay Gap signs, whether it’s the rallying cry of Black Lives Matter, or surging child poverty across the UK: one thing inequality probably doesn’t mean to you, is city planning. Yet over 80% of the UK population live in urban areas, and the built environment is unequally impacting our health and wellbeing.

Not all urban neighbourhoods were built equal

Urban neighbourhoods designed in the past few decades of vehicle priority tend to be the most damaging to health. Car parks and roads have swallowed up our public spaces, and despite government strategies to reduce vehicle emissions via charging schemes, vehicles continue to dominate our streets.

Perhaps you’ve read headlines such as: “Traffic noise revealed as new urban killer”, or, “Each car in London costs NHS and society £8,000 due to air pollution”. These shocking news stories feature robust scientific evidence from the MRC Centre for Environment and Health, that both traffic noise and air pollution are linked to ill health, and even death.

Newsflash – traffic is bad for us! (more…)

How research is helping to understand and break the self-harm cycle

Rachel Rodrigues sheds light on her research on understanding the brain mechanisms that motivate people to self-harm – can we untangle the circuits to break the cycle?

Many of us will know someone who has self-harmed or may even have personal experience of it. This isn’t surprising considering how common it is, particularly in adolescence and young adulthood. Unfortunately though, only about 20% of young people receive help from clinical services for their self-harm, and as much as 50% aren’t receiving any help, even from people close to them, meaning that they are having to cope with it on their own.

For some people self-harm could become more frequent and intense over time and coupled with it also being the strongest predictor of future suicide attempts, this lack of intervention for self-harm is concerning. The aim of my PhD research within Imperial’s Mood Instability Research Group is to find out why young people continue to self-harm. We hope to translate our findings to improve interventions for self-harm. (more…)

20 Years at Imperial: what have I learnt?

Marking 20 years since Dr John Tregoning arrived at Imperial College London as a PhD student, he reflects on what he’s learnt over his career to date.

On 1 October 1999, I walked out of South Kensington tube station, fresh-faced and ready to start my PhD. 20 years later as I walk out of the same tube station to the same campus of the same university (still fresh-faced I like to think), the question is, have I learnt anything?

Spoiler alert – the answer is yes, but a guarded yes, from a staggeringly low starting point, like Marianas Trench low. Some of what I have learned is fairly niche and only useful if you work in a biomedical lab – like how to open a tightly screwed plastic tube with one hand whilst avoiding infecting yourself with influenza, some are a bit more generally applicable to having a career in science, especially if you are or want to run your own research group, and some grandiosely I think might be applicable to everyone.

School’s out

Working in a university, this may be a bit unnecessary to point out, but education never ends: we are continually learning and evolving. Even if you were able to recall all the facts from school into adulthood it is likely that they are now either outdated or completely irrelevant to the work you do. We need to retrain: to become parents, to become managers, to change roles, to retire gracefully. And for these new roles, there is no pass/fail test to say how well you have done, it is all a bit woolly. So we need effective strategies to learn for life: both for ourselves and for the others – students, children, co-workers – that we might need to train. (more…)

What to expect in the second year of medical school

Eva Tadros reflects on the highs and lows of second year of medical school, from the first taste of clinical placements to undertaking a research project in Thailand.

Ending the first year of medical school on a high, I dedicated my summer to relaxing and forgetting about all things medical-related – but little did I know second year was going to hit fast, and it was going to hit hard.

Second year, along with fifth year, are supposedly the hardest two years of your academic medical school journey, but I don’t think anyone quite prepares you for the range of emotions you’re bound to experience throughout the year. From that sense of pride you get when you finally take a proper patient history, to that indescribable feeling of familiarity as your shoes stick onto the Reynolds café floor on Thursday morning following sports night, to being on the verge of tears after not being to elicit a reflex despite trying for a whole term – second year is an absolute rollercoaster. (more…)

Poor diversity, poor design: the truth about inclusive research and why it matters

inclusive research

Madina Wane reflects on the value of creating an inclusive research culture where everyone in society can feel they can participate and benefit from STEM.

The modern seat belt is a simple but extremely effective innovation that has been saving lives since the 1960s. It is estimated to reduce the risk of death by up to 50% and with over 1 million road traffic deaths per year globally, the seat belt is clearly an important development. With such an impact it is easy to neglect scrutiny of this technology, but we must ask the question: are we all equally protected?

When crash test dummies first became required in the 1960s, US regulators wanted manufacturers to use two types – one based on male physical proportions, and one based on female proportions. However, after several years, regulators conceded and manufacturers were able to use just one dummy, reflecting the ‘average’ male. 50 years on and the consequences of this are clear. A study in 2011, from the University of Virginia’s Center for Applied Biomechanics, determined that female drivers were 47% more likely to suffer severe injuries compared to their male counterparts. Many studies have also highlighted the increased incidence of whiplash in female drivers. 

Although the use of female dummies has since been adopted, these are simply smaller versions of male dummies, not accounting for anatomical differences between the sexes. In addition, the female dummy is based on proportions of the smallest 5% of females, rather than the average. To add even more pitfalls, the ‘female’ dummies are still not used to the same extent as their male counterparts, with male dummies predominantly used in the driver’s seat and female dummies more often used in the passenger seat. (more…)

Under pressure: how raising awareness of a silent killer can save lives on a global scale

blood pressure screening

Professor Neil Poulter puts blood pressure screening in the spotlight – an effective way of reducing the burden of high blood pressure in the UK and globally.

Blood pressure screening can save lives, which may come as a surprise considering it is such a simple measurement. Blood Pressure UK was set up as a charity aimed at lowering the nation’s blood pressure (UK), with the purpose of preventing or at least reducing disability and death associated with raised blood pressure (BP).  Among their activities, they have been running a ‘Know Your Numbers’ week every year since 2007, and their thirteenth consecutive campaign week is currently underway. ‘Pressure stations’ have been set up around the UK providing free BP screening, encouraging adults across the country to know their blood pressure numbers. (more…)