Identification of host-pathogen-disease relationships using a scalable multiplex serology platform in UK Biobank

Certain infectious agents are recognised causes of cancer and other chronic diseases. To understand the pathological mechanisms underlying such relationships, here we design a Multiplex Serology platform to measure quantitative antibody responses against 45 antigens from 20 infectious agents including human herpes, hepatitis, polyoma, papilloma, and retroviruses, as well as Chlamydia trachomatis, Helicobacter pylori and Toxoplasma gondii, then assayed a random subset of 9695 UK Biobank participants. We find seroprevalence estimates consistent with those expected from prior literature and confirm multiple associations of antibody responses with sociodemographic characteristics (e.g., lifetime sexual partners with C. trachomatis), HLA genetic variants (rs6927022 with Epstein-Barr virus (EBV) EBNA1 antibodies) and disease outcomes (human papillomavirus-16 seropositivity with cervical intraepithelial neoplasia, and EBV responses with multiple sclerosis). Our accessible dataset is one of the largest incorporating diverse infectious agents in a prospective UK cohort offering opportunities to improve our understanding of host-pathogen-disease relationships with significant clinical and public health implications.

Trends in HIV infection surveillance data among men who have sex with men in Norway, 1995-2011

BACKGROUND

Recent reports on the growing HIV epidemic among men who have sex with men (MSM) in the EU/EEA area were accompanied by an increase of reported HIV among MSM in Oslo, Norway in 2003. Our study with data from 1995 to 2011 has described the recent trends of HIV among MSM in Norway and their socio-demographic and epidemiological characteristics.

METHODS

The data were collected from the Norwegian Surveillance System for Communicable Diseases. Cases were described by age, place of infection, clinical presentation of HIV infection, STI co-infection and source partner. We used simple linear regression to estimate trends over time.

RESULTS

During the study period, 991 MSM, aged from 16 to 80 years, were newly diagnosed with HIV. No significant trends over time in overall median age (36 years) were observed. Most of the MSM (505, 51%) were infected in Oslo. In the years 1995-2002, 30 to 45 MSM were diagnosed with HIV each year, while in the years 2003-2011 this increased to between 56 and 97 cases. The proportion of MSM, presenting with either AIDS or HIV illness, decreased over time, while asymptomatic and acute HIV illness increased (p for trend=0.034 or less). STI co-infection was reported in 133 (13%) cases. An overall increase of syphilis co-infected cases was observed (p for trend <0.001). A casual partner was a source of infection in 590 cases (60%).

CONCLUSIONS

Though the increases described could be attributed to earlier testing and diagnosis, no change in the median age of cases was observed. This indicates that it is likely that there has been an increase in HIV infections among MSM in Norway since 2003. The simultaneous increase in STI co-infections indicates risky sexual behaviour and a potential to spread both HIV and other sexually transmitted infections.

The HIV positive dentist in the United Kingdom - the dilemma of the undiagnosed clinician

This article considers the position of the HIV positive dentist in the United Kingdom who is unaware of their HIV status, or who at least has had no positive HIV test result. It outlines the current UK guidance that relates to HIV positive dentists, and the challenges to those guidelines. It considers how the behaviour of a practising seropositive dentist who has had no positive test result might be interpreted by regulatory bodies and the courts, and highlights the importance of clinicians being fully aware of their HIV status.

How does the HIV epidemic in NSW compare to other Australian jurisdictions and internationally?

AIM

To review the epidemiology of HIV in NSW and compare HIV rates in NSW with those of other comparable jurisdictions.

METHOD

The rate of newly diagnosed cases of HIV reported in NSW was compared with those published from other Australian and comparable international jurisdictions.

RESULTS

Until recent years, NSW has consistently reported the highest rate of newly diagnosed HIV infections in Australia with a peak of 29.1 per 100,000 population in 1987. Since then the notification rate has decreased significantly and has been stable since 2000 at an average annual rate of 5.6 per 100,000. Rates in NSW and in other Australian states and territories are lower than most comparable international jurisdictions, although stability in rates has been observed elsewhere. Between 1984 and 2008, 82% of infections that reported a risk exposure occurred among men who have sex with men.

CONCLUSION

Rates of HIV infection in NSW have been stable over the last decade, remaining among the highest in Australia but lower than those in other comparable industrialised jurisdictions. In NSW, the majority of cases continue to occur among men who have sex with men.