Imperial College London

PROFESSOR AJIT LALVANI

Faculty of MedicineNational Heart & Lung Institute

Chair in Infectious Diseases
 
 
 
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Contact

 

+44 (0)20 7594 0883a.lalvani

 
 
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Assistant

 

Dr Luis Berrocal Almanza +44 (0)20 7594 3721

 
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Location

 

Medical SchoolSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

276 results found

Lalvani A, Connell DW, 2012, Dissecting the immunological, antimicrobial and clinical effects of vitamin D therapy in tuberculosis, PATHOGENS AND GLOBAL HEALTH, Vol: 106, Pages: 378-379, ISSN: 2047-7724

Journal article

Dhasmana D, Bradley C, Connell D, George P, Singanayagam A, Jepson A, Craig C, Wright C, Molyneaux PL, Lalvani A, Cooke G, Kon OMet al., 2012, Improved and immediate diagnostics in mediastinal sarcoid lymphadenopathy via endobronchial ultrasound and quadruple testing, European Respiratory Society Meeting

Conference paper

Pareek M, Baussano I, Abubakar I, Dye C, Lalvani Aet al., 2012, Evaluation of Immigrant Tuberculosis Screening in Industrialized Countries, EMERGING INFECTIOUS DISEASES, Vol: 18, Pages: 1422-1429, ISSN: 1080-6040

Journal article

Lalvani A, Pareek M, 2012, Immigrant screening for TB: a missed opportunity to improve TB control in the United Kingdom, PATHOGENS AND GLOBAL HEALTH, Vol: 106, Pages: 5-7, ISSN: 2047-7724

Journal article

Thillai M, Potiphar L, Eberhardt C, Pareek M, Dhawan R, Kon OM, Wickremasinghe M, Wells A, Mitchell D, Lalvani Aet al., 2012, Obstructive lung function in sarcoidosis may be missed, especially in older white patients, EUROPEAN RESPIRATORY JOURNAL, Vol: 39, Pages: 775-777, ISSN: 0903-1936

Journal article

Aranday-Cortes E, Hogarth PJ, Kaveh DA, Whelan AO, Villarreal-Ramos B, Lalvani A, Vordermeier HMet al., 2012, Transcriptional Profiling of Disease-Induced Host Responses in Bovine Tuberculosis and the Identification of Potential Diagnostic Biomarkers, PLOS ONE, Vol: 7, ISSN: 1932-6203

Journal article

Singanayagam A, Sridhar S, Dhariwal J, Abdel-Aziz D, Munro K, Connell DW, George PM, Molyneaux PL, Cooke GS, Burroughs AK, Lalvani A, Wickremasinghe M, Kon OMet al., 2012, A comparison between two strategies for monitoring hepatic function during antituberculous therapy, Am J Respir Crit Care Med, Vol: 185, Pages: 653-659, ISSN: 1535-4970

RATIONALE: The optimum strategy for monitoring liver function during antituberculous therapy is unclear. OBJECTIVES: To assess the value of the American Thoracic Society risk-factor approach for predicting drug-induced liver injury and to compare with a uniform policy of liver function testing in all patients at 2 weeks. METHODS: We conducted an observational study of adult patients undergoing therapy for active tuberculosis at a tertiary center. All patients had alanine transferase measurement at baseline and 2 weeks following commencement of therapy. Sensitivity, specificity, and positive and negative predictive values were used to assess strategies. MEASUREMENTS AND MAIN RESULTS: There were 288 patients included, and 21 (7.3%) developed drug-induced liver injury (57.1% "early" at 2 wk and 42.9% "late," after 2 wk). There were increased rates of individuals with HIV infection in the early drug-induced liver injury group compared with no drug-induced liver injury and late drug-induced liver injury groups (33% vs. 7.1% vs. 0%; P = 0.004). The American Thoracic Society algorithm had a sensitivity and specificity of 66.7 and 65.6%, respectively, for prediction of early and 22.2% and 63.7% for late drug-induced liver injury. The uniform monitoring policy had poor sensitivity but better specificity (22.2 and 82.1%) for prediction of late drug-induced liver injury. CONCLUSIONS: In our urban, ethnically diverse population, a risk-factor approach is neither sensitive nor specific for prediction of drug-induced liver injury. A uniform policy of liver function testing at 2 weeks is useful for prompt identification of a subgroup who develop early drug-induced liver injury and may offer better specificity in ruling out late drug-induced liver injury.

Journal article

Pollock KM, Tam H, Grass L, Bowes S, Cooke GS, Pareek M, Montamat-Sicotte D, Kapembwa M, Taylor GP, Lalvanil Aet al., 2012, Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study, BMJ Open, Vol: 2, ISSN: 2044-6055

Background HIV is the most important risk factor for progression of latent tuberculosis infection (LTBI) to active tuberculosis (TB). Detection and treatment of LTBI is necessary to reduce the increasing burden of TB in the UK, but a unified LTBI screening approach has not been adopted.Objective To compare the effectiveness of a TB risk-focused approach to LTBI screening in the HIV-positive population against current UK National Institute for Health and Clinical Excellence (NICE) guidance.Design Prospective cohort study.Setting Two urban HIV treatment centres in London, UK.Participants 114 HIV-infected individuals with defined TB risk factors were enrolled prospectively as part of ongoing studies into HIV and TB co-infection.Outcome measures The yield and case detection rate of LTBI cases within the research study were compared with those generated by the NICE criteria.Results 17/114 (14.9%, 95% CI 8.3 to 21.5) had evidence of LTBI. Limiting screening to those meeting NICE criteria for the general population (n=43) would have detected just over half of these, 9/43 (20.9%, 95% CI 8.3 to 33.5) and those meeting criteria for HIV co-infection (n=74) would only have captured 8/74(10.8%, 95% CI 3.6 to 18.1) cases. The case detection rates from the study and NICE approaches were not significantly different. LTBI was associated with the presence of multiple TB risk factors (p=0.002).Conclusion Adoption of a TB risk-focused screening algorithm that does not use CD4 count stratification could prevent more cases of TB reactivation, without changing the case detection rate. These findings should be used to inform a large-scale study to create unified guidelines.

Journal article

Pareek M, Evans J, Innes J, Smith G, Hingley-Wilson S, Lougheed KE, Sridhar S, Dedicoat M, Hawkey P, Lalvani Aet al., 2012, Ethnicity and mycobacterial lineage as determinants of tuberculosis disease phenotype, Thorax, ISSN: 1468-3296

BACKGROUND: Emerging evidence suggests that Mycobacterium tuberculosis (Mtb) lineage and host ethnicity can determine tuberculosis (TB) clinical disease patterns but their relative importance and interaction are unknown. METHODS: We evaluated prospectively collected TB surveillance and Mtb strain typing data in an ethnically heterogeneous UK population. Lineage assignment was denoted using 15-loci mycobacterial interspersed repetitive units containing variable numbers of tandem repeats (MIRU-VNTR) and MIRU-VNTRplus. Geographical and ethnic associations of the six global Mtb lineages were identified and the influence of lineage and demographic factors on clinical phenotype were assessed using multivariate logistic regression. RESULTS: Data were available for 1070 individuals with active TB which was pulmonary only, extrapulmonary only and concurrent pulmonary-extrapulmonary in 52.1%, 36.9% and 11.0% respectively. The most prevalent lineages were Euro-American (43.7%), East African Indian (30.2%), Indo-Oceanic (13.6%) and East Asian (12.2%) and were geo-ethnically restricted with, for example, Indian subcontinent ethnicity inversely associated with Euro-American lineage (OR 0.23; 95% CI 0.14 to 0.39) and positively associated with the East African-Indian lineage (OR 4.04; 95% CI 2.19 to 7.45). Disease phenotype was most strongly associated with ethnicity (OR for extrathoracic disease 21.14 (95% CI 6.08 to 73.48) for Indian subcontinent and 14.05 (3.97 to 49.65) for Afro-Caribbean), after adjusting for lineage. With East Asian lineage as the reference category, the Euro-American (OR 0.54; 95% CI 0.32 to 0.91) and East-African Indian (OR 0.50; 95% CI 0.29 to 0.86) lineages were negatively associated with extrathoracic disease, compared with pulmonary disease, after adjusting for ethnicity. CONCLUSIONS: Ethnicity is a powerful determinant of clinical TB phenotype independently of mycobacterial lineage and the role of ethnicity-associated factors in pathogenesis warrants

Journal article

Thillai M, Eberhardt C, Lewin AM, Potiphar L, Hingley-Wilson S, Sridhar S, Macintyre J, Kon OM, Wickremasinghe M, Wells A, Weeks ME, Mitchell D, Lalvani Aet al., 2012, Sarcoidosis and tuberculosis cytokine profiles: indistinguishable in bronchoalveolar lavage but different in blood, PLoS One, Vol: 7, ISSN: 1932-6203

BACKGROUND: The clinical, radiological and pathological similarities between sarcoidosis and tuberculosis can make disease differentiation challenging. A complicating factor is that some cases of sarcoidosis may be initiated by mycobacteria. We hypothesised that immunological profiling might provide insight into a possible relationship between the diseases or allow us to distinguish between them. METHODS: We analysed bronchoalveolar lavage (BAL) fluid in sarcoidosis (n = 18), tuberculosis (n = 12) and healthy volunteers (n = 16). We further investigated serum samples in the same groups; sarcoidosis (n = 40), tuberculosis (n = 15) and healthy volunteers (n = 40). A cross-sectional analysis of multiple cytokine profiles was performed and data used to discriminate between samples. RESULTS: We found that BAL profiles were indistinguishable between both diseases and significantly different from healthy volunteers. In sera, tuberculosis patients had significantly lower levels of the Th2 cytokine interleukin-4 (IL-4) than those with sarcoidosis (p = 0.004). Additional serum differences allowed us to create a linear regression model for disease differentiation (within-sample accuracy 91%, cross-validation accuracy 73%). CONCLUSIONS: These data warrant replication in independent cohorts to further develop and validate a serum cytokine signature that may be able to distinguish sarcoidosis from tuberculosis. Systemic Th2 cytokine differences between sarcoidosis and tuberculosis may also underly different disease outcomes to similar respiratory stimuli.

Journal article

Lalvani A, Behr MA, Sridhar S, 2012, Innate immunity to TB: a druggable balancing act, Cell, Vol: 148, Pages: 389-391, ISSN: 1097-4172

Tobin and colleagues show that both inhibition and excessive production of the inflammatory mediator TNFalpha impact the pathogenesis of tuberculosis (TB) and the response to therapy. Identifying a critical role for the genetically determined balance between pro- and anti-inflammatory eicosanoids in regulating TNFalpha levels provides a roadmap to tailored TB treatment based on host genotype.

Journal article

Sridhar S, Begom S, Bermingham A, Ziegler T, Roberts KL, Barclay WS, Openshaw P, Lalvani Aet al., 2012, Predominance of heterosubtypic IFN-gamma-only-secreting effector memory T cells in pandemic H1N1 naive adults, Pages: 2913-2924, ISSN: 1521-4141

The 2009/10 pandemic (pH1N1) highlighted the need for vaccines conferring heterosubtypic immunity against antigenically shifted influenza strains. Although cross-reactive T cells are strong candidates for mediating heterosubtypic immunity, little is known about the population-level prevalence, frequency, and cytokine-secretion profile of heterosubtypic T cells to pH1N1. To assess this, pH1N1 sero-negative adults were recruited. Single-cell IFN-gamma and IL-2 cytokine-secretion profiles to internal proteins of pH1N1 or live virus were enumerated and characterised. Heterosubtypic T cells recognising pH1N1 core proteins were widely prevalent, being detected in 90% (30 of 33) of pH1N1-naive individuals. Although the last exposure to influenza was greater than 6 months ago, the frequency and proportion of the IFN-gamma-only-secreting T-cell subset was significantly higher than the IL-2-only-secreting subset. CD8(+) IFN-gamma-only-secreting heterosubtypic T cells were predominantly CCR7(-) CD45RA(-) effector-memory phenotype, expressing the tissue-homing receptor CXCR3 and degranulation marker CD107. Receipt of the 2008-09 influenza vaccine did not alter the frequency of these heterosubtypic T cells, highlighting the inability of current vaccines to maintain this heterosubtypic T-cell pool. The surprisingly high prevalence of pre-existing circulating pH1N1-specific CD8(+) IFN-gamma-only-secreting effector memory T cells with cytotoxic and lung-homing potential in pH1N1-seronegative adults may partly explain the low case fatality rate despite high rates of infection of the pandemic in young adults.

Conference paper

Dosanjh DPS, Bakir M, Millington KA, Soysal A, Aslan Y, Efee S, Deeks JJ, Lalvani Aet al., 2011, Novel <i>M tuberculosis</i> Antigen-Specific T-Cells Are Early Markers of Infection and Disease Progression, PLOS ONE, Vol: 6, ISSN: 1932-6203

Journal article

Asgheddi M, Connell DW, Nooredinvand HA, Abdullah M, O'Donoghue M, Campbell L, Lalvani A, Wickremasinghe M, Khan S, Kon OMet al., 2011, THE PREVALENCE OF VIRAL HEPATITIS IN PATIENTS UNDERGOING ANTI-TUBERCULOUS THERAPY, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A93-A94, ISSN: 0040-6376

Conference paper

Hingley-Wilson S, Connell D, Pollock K, Min KO, Jacobs W, Lalvani Aet al., 2011, Fractalkine production mediates virulence-associated monocyte recruitment and <i>Mycobacterium tuberculosis</i> infection, Annual Congress of the British-Society-for-Immunology, Publisher: WILEY-BLACKWELL, Pages: 167-167, ISSN: 0019-2805

Conference paper

Pollock KM, Montamat-Sicotte D, Cooke G, Kapembwa M, Kon OM, Taylor GP, Lalvani Aet al., 2011, POLYFUNCTIONAL T CELLS REVEAL THE SPECTRUM OF TUBERCULOSIS IN HIV CO-INFECTION THROUGH THE IDENTIFICATION OF IMMUNOLOGICAL CORRELATES OF LATENT AND ACTIVE DISEASE, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A22-A23, ISSN: 0040-6376

Conference paper

Dhasmana DJ, Bradley CJ, George P, Connell DW, Molyneaux P, Singanayagam A, Lalvani A, Jepson A, Kon OM, Cooke GSet al., 2011, GENEXPERT MTB.RIF ASSAY IMPROVES THE DIAGNOSTIC YIELD OF EBUS-TBNA IN SMEAR-NEGATIVE INTRA-THORACIC TUBERCULOUS LYMPHADENOPATHY, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A75-A75, ISSN: 0040-6376

Conference paper

Almond MH, O'Donoghue M, Drey N, Seneviratne S, Lalvani A, Wickremasinghe M, Kon OMet al., 2011, INTERFERON-GAMMA RELEASE ASSAY (IGRA) CONVERSION, REVERSION AND IMPLICATIONS FOR THE DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION USING A MULTIMODALITY APPROACH: A RETROSPECTIVE, OBSERVATIONAL STUDY WITHIN A CENTRAL LONDON TB CENTRE, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A72-A72, ISSN: 0040-6376

Conference paper

Pareek M, Bond M, Shorey J, Seneviratne S, Lalvani A, Kon OMet al., 2011, COMMUNITY-BASED EVALUATION OF IMMIGRANT TB SCREENING USING INTERFERON GAMMA RELEASE ASSAYS AND TUBERCULIN SKIN TESTING: YIELDS AND COST-EFFECTIVENESS, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A20-A20, ISSN: 0040-6376

Conference paper

Kasprowicz VO, Churchyard G, Lawn SD, Squire SB, Lalvani Aet al., 2011, Diagnosing Latent Tuberculosis in High-Risk Individuals: Rising to the Challenge in High-Burden Areas, JOURNAL OF INFECTIOUS DISEASES, Vol: 204, Pages: S1168-S1178, ISSN: 0022-1899

Journal article

Pareek M, Abubakar I, White PJ, Garnett GP, Lalvani Aet al., 2011, UK immigrant screening is inversely related to regional tuberculosis burden, THORAX, Vol: 66, Pages: 1010-1010, ISSN: 0040-6376

Journal article

Navani N, Molyneaux PL, Breen RA, Connell DW, Jepson A, Nankivell M, Brown JM, Morris-Jones S, Ng B, Wickremasinghe M, Lalvani A, Rintoul RC, Santis G, Kon OM, Janes SMet al., 2011, Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study, THORAX, Vol: 66, Pages: 889-893, ISSN: 0040-6376

Journal article

Kasprowicz VO, Mitchell JE, Chetty S, Govender P, Huang K-HG, Fletcher HA, Webster DP, Brown S, Kasmar A, Millington K, Day CL, Mkhwanazi N, McClurg C, Chonco F, Lalvani A, Walker BD, Ndung'u T, Klenerman Pet al., 2011, A Molecular Assay for Sensitive Detection of Pathogen-Specific T-Cells, PLOS ONE, Vol: 6, ISSN: 1932-6203

Journal article

Bwalya AG, Stapleton P, Phiri P, Montamat SD, Hingley WS, Lalvani A, Tasdemir Det al., 2011, Screening of Zambian <i>Ficus</i> species for antibacterial and antimycobacterial activity, 59th International Congress and Annual Meeting of the Society-for-Medicinal-Plant-and-Natural-Product-Research, Publisher: GEORG THIEME VERLAG KG, Pages: 1383-1383, ISSN: 0032-0943

Conference paper

Gideon HP, Flynn JL, 2011, Latent tuberculosis: what the host "sees"?, IMMUNOLOGIC RESEARCH, Vol: 50, Pages: 202-212, ISSN: 0257-277X

Journal article

Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ, Abubakar I, Lalvani Aet al., 2011, Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis, LANCET INFECTIOUS DISEASES, Vol: 11, Pages: 435-444, ISSN: 1473-3099

Journal article

Montamat-Sicotte DJ, Millington KA, Willcox CR, Hingley-Wilson S, Hackforth S, Innes J, Kon OM, Lammas DA, Minnikin DE, Besra GS, Willcox BE, Lalvani Aet al., 2011, A mycolic acid-specific CD1-restricted T cell population contributes to acute and memory immune responses in human tuberculosis infection, JOURNAL OF CLINICAL INVESTIGATION, Vol: 121, Pages: 2493-2503, ISSN: 0021-9738

Journal article

Suzgec-Selcuk S, Mericli AH, Guven KC, Kaiser M, Casey R, Hingley-Wilson S, Lalvani A, Tasdemir Det al., 2011, Evaluation of Turkish Seaweeds for Antiprotozoal, Antimycobacterial and Cytotoxic Activities, PHYTOTHERAPY RESEARCH, Vol: 25, Pages: 778-783, ISSN: 0951-418X

Journal article

Pareek M, Abubakar I, White PJ, Garnett GP, Lalvani Aet al., 2011, Tuberculosis screening of migrants to low-burden nations: insights from evaluation of UK practice, EUROPEAN RESPIRATORY JOURNAL, Vol: 37, Pages: 1175-1182, ISSN: 0903-1936

Journal article

Broniatowska B, Allmendinger A, Kaiser M, Montamat-Sicotte D, Hingley-Wilson S, Lalvani A, Guiry M, Blunden G, Tasdemir Det al., 2011, Antiprotozoal, Antitubercular and Cytotoxic Potential of Cyanobacterial (Blue-Green Algal) Extracts from Ireland, NATURAL PRODUCT COMMUNICATIONS, Vol: 6, Pages: 689-694, ISSN: 1934-578X

Journal article

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