Emeritus Professor Andrew Lloyd

Emeritus Professor Andrew Lloyd

Professor
Medicine & Health
The Kirby Institute

Professor Andrew Lloyd is an infectious diseases physician, and an epidemiology, virology and immunology researcher. He is an NHMRC Practitioner Fellow. He is the Head of the Viral Immunology Systems Program (VISP) in the Kirby Institute, and Director of the UNSW Fatigue Clinic and Research Program at the University of NSW. He also provides clinical services in infectious diseases at Prince of Wales Hospital, and hepatology services to Justice Health in the NSW prisons. His research program...

Phone
+61 (2) 9385 2534
E-mail
a.lloyd@unsw.edu.au

Member, Order of Australia (A.M): “For service to medicine and the community, particularly through provision of hepatitis services in prisons, and research in infectious diseases”.

The focus of VISP is investigation of the immunological and virological determinants of pathogenesis of RNA virus infections, particular hepatitis C, dengue virus and SARS CoV-2. These studies are funded by an NHMRC Program Grant and NHMRC Investigator Grants to two early and senior career researchers, Dr Chaturaka Rodrigo and A/Professor Rowena Bull. The studies are based on samples collected from clinical cohorts, including: the previous NHMRC Project funded HITS-p cohort (Hepatitis C Incidence and Transmission Study in prisons); the NHMRC Partnership Project funded Surveillance and Treatment of hepatitis C in prisoners (SToP-C) projects; and the NHMRC Project Grant funded Study of Hepatitis C Treatment and Reinfection in People who inject drugs in the prisons (SHARP-p), the University of Colombo Dengue cohort, and the Snow Foundation funded COSiN cohort studying immunological outcomes after SARS CoV-2 infection. The studies examine samples from these cohorts are based on cutting edge cellular and molecular assay techniques including next generation sequencing of viruses, multi-colour flow cytometry to characterise virus-specific B and T cell responses, neutralisation assays, enzyme-linked immunospot (ELISpot) and mutliplex cytokine detection assays, as well as high throughput single cell transcriptomics.

The clinical aspects of the research program are focused firstly on the prison context where chronic viral hepatitis is prevalent. Initial studies included the development and evaluation of an innovative nurse-led model of hepatitis care in the New South Wales (NSW) prisons, which has now been rolled out across the state. In the Surveillance and Treatment of hepatitis C in prisoners (SToP-C) project the efficacy of scale-up of testing and antiviral treatment in prevention of new hepatitis C infections (that is treatment-as-prevention; TasP) has been examined in four NSW prisons. This world-first study demonstrated halving of the transmission rate. Ongoing studies include mathematical modelling of the impact of scale-up in the prisons on the community at large, and the cost-effectiveness of the intervention. The Study of Hepatitis C Treatment and Reinfection in People who inject drugs in the prisons (SHARP-p) is a prospective cohort study following prisoners receiving antiviral treatment for chronic hepatitis C for reinfection - to estimate the incidence and predictors of this outcome in the prison context.

The second clinical program is studying determinants of the severity and course of fatigue states after common acute infections (i.e. post-infective fatigue syndrome; PIFS), and in more established chronic fatigue states. This research is conducted in close collaboration with the UNSW Fatigue Clinic which offers cognitive-behavioural therapy (CBT) and graded exercise therapy (GET) treatment interventions. The PIFS research is based on data and samples previously collected in the Dubbo Infection Outcomes Study which was funded by the Centers for Disease Control, USA and NHMRC, and also on data samples from the international Collaborative on Fatigue Following Infection (COFFI) which includes more than 10 comparable prospective post-infective cohorts. The current focus is on epidemiological studies to identify reliable predictors of PIFS and on genetic association of PIFS - funded by the Mason Foundation.