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Effective vaccine must deal with extreme HIV-1 variability and do so without guidance from natural immunity. For HIV-1, vaccines may need to induce both bNAbs and protective CD8+ killer T cells, the latter of which clearly impose a selective pressure on the virus and their protective potential should be harnessed by vaccines. However, not all antibodies and CD8+ T cells are protective; they must target vulnerable parts on HIV-1 proteins.

The central paradigm of the HIVconsvX T-cell vaccine strategy is focusing T cells on the functionally conserved regions of the HIV-1 Gag and Pol proteins, which are very similar among global isolates and harbour fewer escape mutations. At the epitope level, the remaining variability within the conserved regions is addressed computationally by using a bi-valent mosaic. Results of the first trials testing the HIVconsvX vaccine candidates confirmed that conserved sub-dominant and, therefore, underused T-cell epitopes taken out of the context of the whole virus or full-length viral proteins can induce robust and broad T-cell responses when delivered by an effective heterologous regimen such as ChAdOx1-MVA.

Progress towards an effective HIV-1 vaccine has been slow and riddled with many setbacks. However, systematic iterative development of vaccine components for both neutralizing antibodies and effective T cells informed by human data is beginning to pay off by bringing the first encouragements endorsing the field’s overall direction of travel.

Trichophyton indotinaea is a newly described species of dermatophyte that has emerged with the last 10 years in India, and some Middle Eastern countries. It causes tinea corporis and tinea cruris mainly (ringworm infection of the torso and groin) and can spread to the arms, legs and face. T. indotineae is also characterised by a reduced susceptibility or outright resistance to one of the commonly used and otherwise highly effective antifungals, terbinafine. While high levels of cases are seen in Indida, countries outside of India and the Middle East are now seeing imported cases and the UK is not alone. Working with colleagues in London we have identified signficant numbers of cases and are now understanding how difficult these infections are to treat, even with antifungals that the organism should be sensitive to. Lesions are only superficial, but are itchy and disfiguring, and often relapse after initial antifungal therapy. We are continuing to learn about the epidemiology, transmission, diagnosis and treatment of this emerging infection.

Despite effective treatments and vaccines viral hepatitis remains a massive burden on global health affecting the poorest counties disproportionately. Effective treatments and diagnostics for hepatitis remain outside the reach of most people in resource-poor regions.

In contrast, UK strategies against viral hepatitis have been relatively successful, in particular the prospect of HCV elimination, which is already showing improved outcomes in liver health.

Effective strategies depend on high quality epidemiological data which is gleaned from a wide variety of sources including diagnostic laboratory reporting, sentinel surveillance programs and prospective screening of high-risk groups.

The key components preventing transmission of blood-borne viruses such as donor screening, surveillance of susceptible groups and vaccination are now further enhanced by retrospective case finding from historical data, opt-out screening in emergency departments and high intensity test-and-treat events in prisons.

Biomedical Scientists can make a valuable contribution towards viral hepatitis management by sharing local-level data, enabling practical testing solutions for marginalised groups and working closely with clinical teams.

Who lives in a papaya under the sea? SpongeBob Alloadsorption Pants! A Transfusion Laboratory Perspective of AIHA

The debate about performance and sustainability of our healthcare services is often reduced to a questions of money and beds are there enough of either? Both are back ups to the more important question - are there enough staff?

The size and complexity of the workforce challenge means there will need to be concerted and sustained action across the system on workforce planning, training, retention, productivity, job roles and creating workplace cultures - that demonstrates staff are valued. For our sector, action is needed both in the short term and the long term to support the workforce and meet the needs of our service and how this will meet the wider healthcare service for patients.

This presentation will look at how leaders at all levels need to work collectively to address our workforce challenge and how we can together take action at a local, regional and national level.

This cases study focusses on a paient that showed dual positivity for Anti-GBM and Anti-PLA2r antibodies. It will look at how testing was requested, the methods used for the investigations and how the results lead to the conclusions drawn.

It will also look at testing algorithms in the Immunology laboratory, related to these investigations and how these could be improved.

The analysis of free light chains in clinical laboratories to support the diagnosis and treatment monitoring of Myeloma has evolved over 6 decades. From urine analysis for Bence Jones Protein using gel electrophoresis in the 1950s to the launch of the first commercial assay for serum free light chain measurement in 2001.

This talk will describe the biochemistry of free light chains and the benefits and challenges of the different methodologies available in laboratories today. I will also describe the complexity of clinical interpretation of results, highlighting relevant national guidance, recently developed diagnostic tools for clinicians and testing advice for laboratories.

A role with a difference – anatomical pathology technologist in a mortuary

Albert Norman Keynote Opening Address

AMR/CSO Diagnostic pathway change – Biomedical Scientist Perspective