Andrew Lloyd

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Source:UNSW Sydney

Andrew R. Lloyd, MB BS Syd, MD UNSW, FRACP, is an infectious disease physician, and an epidemiology, virology and immunology researcher. He is a professor at the School of Medical Sciences, University of New South Wales, Sydney, Australia.[1]

He is one of the authors of the 2002 Australian chronic fatigue syndrome (CFS) guidelines, which were immediately criticized by ME/CFS Australia[2] who stated the guidelines:

  • do not describe accurately and fully the symptoms and characteristics of the illness;
  • misrepresent the illness and people with CFS;
  • do not provide an accurate, balanced and objective consideration of the research evidence;
  • demonstrate a consistent bias towards a psychiatric-psychological approach to the illness;
  • dismiss, downplay or ignore biological evidence;
  • make illness management suggestions that are potentially harmful for many with CFS; and
  • do not mention other ways of effectively managing the illness.[3]

In a following letter to the Medical Journal of Australia, ME/CFS Australia stated:

"Following an extensive review of the literature, it is considered that the evidence is not good enough for the Guidelines to be called ‘evidence-based,’ the assessment and presentation of the evidence has not been objective, the Working Group was not truly representative and so the end product is unreliable. The document provides potentially harmfulmanagement suggestions with insufficient supporting evidence."[4]

More than 700 people signed a petition[5] asking him to stop the roll out of training medical professionals to use CBT and GET on people diagnosed with chronic fatigue syndrome. The university responded, stating the people who are protesting harbour ‘resentment against the notion that CFS may have psychological causes’[6], while there is no evidence for their argument.

Lloyd is on the Australian government's ME and CFS advisory committee[7].

Lloyd described the PACE trial has having "reasonably solid data".[8]

Awards[edit | edit source]

  • 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”[9]

Clinic[edit | edit source]

  • The Fatigue Centre, Newtown, New South Wales, Australia, was created and is supervised by Dr. Andrew Lloyd to serve patients with CFS and post-cancer fatigue.
  • David Tuller met with patients of the clinic, who 'reported that their experience included some positive and some very negative aspects'.[10]

Book Chapters[edit | edit source]

  • 1999, "Chronic fatigue syndrome: current concepts of pathogenesis and treatment," in Current Clinical Topics in Infectious Diseases, edn. Original[11]
  • 2005, "Fatigue states following infection," in Infectious Diseases A clinical approach, edn. 2[12]

Notable studies[edit | edit source]

  • 1990, A double-blind, placebo-controlled trial of intravenous immunoglobulin therapy in patients with chronic fatigue syndrome[13]
  • 1997, Intravenous immunoglobulin is ineffective in the treatment of patients with chronic fatigue syndrome[14]
  • 1998, Chronic fatigue syndrome: An immunological perspective[15]
  • 2003, Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution[16] (Full Text)
  • 2006, Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: Prospective cohort study[17] (Abstract)
  • 2006, Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus[18] (Full Text)
  • 2006, Prolonged Illness after Infectious Mononucleosis Is Associated with Altered Immunity but Not with Increased Viral Load (Full Text)[19]
  • 2007, Postinfective fatigue syndrome is not associated with altered cytokine production[20]
  • 2007, Fatigue: case definition and guidelines for collection, analysis, and presentation of immunization safety data[21] (Preview)
  • 2010, Serum Cytokine Levels in Postinfective Fatigue Syndrome (Full Text)[22]
  • 2010, Autonomic hyper-vigilance in post-infective fatigue syndrome[23]
  • 2010, Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome[24]
  • 2011, Sleep-wake behavior in chronic fatigue syndrome[25]
  • 2012, Reduced Cardiac Vagal Modulation Impacts on Cognitive Performance in Chronic Fatigue Syndrome[26]
  • 2015, Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome[27]
  • 2016, University of NSW tests graded activity program on mild chronic fatigue syndrome patients[28]
  • 2016, Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome[29]
  • 2016, Outcomes and predictors of response from an optimised, multidisciplinary intervention for chronic fatigue states[30]
  • 2016, Gene Expression in Response to Exercise in Patients with Chronic Fatigue Syndrome: A Pilot Study (Full Text)[31]
  • 2016, Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions[32]
  • 2016, The natural history of acute Q fever: A prospective Australian cohort[33]
  • 2017, Cytokine signature in chronic fatigue syndrome[34]
  • 2017, Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome[35] [pubmed:30741357](Abstract)
  • 2018, Personalised relaxation practice to improve sleep and functioning in patients with chronic fatigue syndrome and depression: study protocol for a randomised controlled trial[36] (Full Text)
  • 2018, The International Collaborative on Fatigue Following Infection (COFFI)[37] (Full text)
  • 2019, The Invisible Burden of Chronic Fatigue in the Community: a Narrative Review[38] (Abstract)

Talks and interviews[edit | edit source]

Online presence[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. https://medicalsciences.med.unsw.edu.au/people/professor-andrew-lloyd
  2. "ME/CFS Australia (SA) Inc: Letter to eMJA (March 7, 2002)". sacfs.asn.au. Retrieved October 2, 2018.
  3. "ME/CFS Australia (SA) Inc: Letter to eMJA (March 7, 2002)". sacfs.asn.au. Retrieved October 2, 2018.
  4. "ME/CFS Australia (SA) Inc: Letter to eMJA (April 24, 2002)". sacfs.asn.au. Retrieved October 2, 2018.
  5. "Stop graded exercise therapy trial at University of NSW". #MEAction. Retrieved October 2, 2018.
  6. "Lloyd's university responds: CBT/GET training trial for chronic fatigue syndrome". ME Australia. March 30, 2017. Retrieved October 2, 2018.
  7. "Australian government's ME and CFS advisory committee". ME Australia. April 23, 2018. Retrieved October 2, 2018.
  8. "How the UNSW chronic fatigue syndrome studies use 'potentially harmful' guidelines". ME Australia. March 31, 2016. Retrieved October 2, 2018.
  9. https://medicalsciences.med.unsw.edu.au/people/professor-andrew-lloyd
  10. "Trial By Error: A Post About Andrew Lloyd". Virology blog. Retrieved October 2, 2018.
  11. Current Clinical Topics in Infectious Diseases, edn. Original, Blackwell Science Asia, Carlton, Victoria, pp. 138 - 159
  12. Yung A; McDonald M; Spelman D; Street A; Johnson P; Sorrell T; McCormack J (ed.), Infectious Diseases A clinical approach, edn. 2, IP Communications, East Hawthorn, Victoria, Australia, pp. 195 - 204
  13. Lloyd, A.; Hickie, I.; Wakefield, D.; Boughton, C.; Dwyer, J. (November 1990), "A double-blind, placebo-controlled trial of intravenous immunoglobulin therapy in patients with chronic fatigue syndrome", The American Journal of Medicine, 89 (5): 561–568, ISSN 0002-9343, PMID 2146875
  14. Vollmer-Conna, U; Hickie, I; Hadzi-Pavlovic, D; Tymms, K; Wakefield, D; Dwyer, J; Lloyd, A (1997). "Intravenous immunoglobulin is ineffective in the treatment of patients with chronic fatigue syndrome". American Journal of Medicine. 103: 38–43. doi:10.1016/S0002-9343(97)90045-0.
  15. Vollmer-Conna U;Lloyd A;Hickie I;Wakefield D, 1998, 'Chronic fatigue syndrome: An immunological perspective', Australian and New Zealand Journal of Psychiatry, vol. 32, pp. 523 - 527
  16. Reeves, W.C.; Lloyd, A.; Vernon, S.D.; Klimas, N.; Jason, L.A.; Bleijenberg, G.; Evengard, B.; White, P.D.; Nisenbaum, R.; Unger, E. (2003), "Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution", BMC Health Services Research, 3 (25), doi:10.1186/1472-6963-3-25
  17. Hickie, Ian; Davenport, Tracey; Wakefield, Denis; Vollmer-Conna, Ute; Cameron, Barbara; Vernon, Suzanne D; Reeves, William C; Lloyd, Andrew (September 16, 2006). "Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study". BMJ. 333 (7568): 575–. doi:10.1136/bmj.38933.585764.ae. PMC 1569956. PMID 16950834.
  18. Vernon, SD; Whistler, T; Cameron, B; Hickie, IB; Reeves, WC; Lloyd, A (2006). "Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus". BMC Infectious Diseases. 6 (15). doi:10.1186/1471-2334-6-15. PMID 16448567.
  19. Cameron, Barbara; Bharadwaj, Mandvi; Burrows, Jacqueline; Fazou, Chrysa; Wakefield, Denis; Hickie, Ian; Ffrench, Rosemary; Khanna, Rajiv; Lloyd, Andrew (2006), "Prolonged Illness after Infectious Mononucleosis Is Associated with Altered Immunity but Not with Increased Viral Load", Journal Infectious Disease, 193 (5): 664-671, doi:10.1086/500248
  20. Vollmer-Conna U; Cameron B; Hadzi-Pavlovic D; Singletary K; Davenport T; Vernon S; Reeves WC; Hickie I; Wakefield D; Lloyd AR, 2007, 'Postinfective fatigue syndrome is not associated with altered cytokine production', Clinical Infectious Diseases, vol. 45, pp. 732 - 735, http://dx.doi.org/10.1086/520990
  21. Jones, James F.; Kohl, Katrin S.; Ahmadipour, Nooshin; Bleijenberg, Gijs; Buchwald, Dedra; Evengard, Birgitta; Jason, Leonard A.; Klimas, Nancy G.; Lloyd, Andrew (August 2007). "Fatigue: Case definition and guidelines for collection, analysis, and presentation of immunization safety data". Vaccine. 25 (31): 5685–5696. doi:10.1016/j.vaccine.2007.02.065. ISSN 0264-410X.
  22. Barbara Cameron, David L. Hirschberg, Yael Rosenberg-Hassan, Dharam Ablashi, Andrew R. Lloyd. (2010). Serum Cytokine Levels in Postinfective Fatigue Syndrome. Clinical Infectious Diseases, 50 (2): 278-280. doi:10.1086/649546
  23. Kadota Y;Cooper G;Burton AR; Lemon J; Schall U; Lloyd A; Vollmer-Conna U, 2010, 'Autonomic hyper-vigilance in post-infective fatigue syndrome', Biological Psychology, vol. 85, pp. 97 - 103, http://dx.doi.org/10.1016/j.biopsycho.2010.05.009
  24. Burton AR; Rahman K; Kadota Y; Lloyd A; Vollmer-Conna U, 2010, 'Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome', Experimental Brain Research, vol. 204, pp. 71 - 78, http://dx.doi.org/10.1007/s00221-010-2296-1
  25. Rahman K;Burton A;Galbraith S;Lloyd A;Vollmer-Conna U, 2011, 'Sleep-wake behavior in chronic fatigue syndrome', Sleep, vol. 34, pp. 671 - 678
  26. Beaumont A;Burton AR;Lemon J;Bennett BK;Lloyd A;Vollmer-Conna U, 2012, 'Reduced Cardiac Vagal Modulation Impacts on Cognitive Performance in Chronic Fatigue Syndrome', PLoS ONE, vol. 7, http://dx.doi.org/10.1371/journal.pone.0049518
  27. Keech A;Sandler C;Vollmer-Conna U;Lloyd A;Barry B, 2015, 'Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome.', in Physiotherapy, Elsevier, Singapore, Vol. 101, pp. e121 - e122, presented at World Congress of Physical Therapy, Singapore, 01 - 04 May 2015, http://dx.doi.org/10.1016/j.physio.2015.03.262
  28. "University of NSW tests graded activity program on mild chronic fatigue syndrome patients". ME Australia. May 9, 2016. Retrieved October 2, 2018.
  29. Sandler CX, Lloyd AR, Barry BK. (2016). Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome. Medicine and Science in Sports Exercise 2016 Oct;48(10):1875-85. doi: 10.1249/MSS.0000000000000983
  30. Sandler CX;Hamilton BA;Horsfield SL;Bennett BK;Vollmer-Conna U;Tzarimas C;Lloyd AR, 2016, 'Outcomes and predictors of response from an optimised, multidisciplinary intervention for chronic fatigue states', Internal Medicine Journal, vol. 46, pp. 1421 - 1429, http://dx.doi.org/10.1111/imj.13251
  31. Keech, A., Vollmer-Conna, U., Barry, B. K., & Lloyd, A. R. (2016). Gene Expression in Response to Exercise in Patients with Chronic Fatigue Syndrome: A Pilot Study. Frontiers in Physiology, 7, 421. http://doi.org/10.3389/fphys.2016.00421
  32. Cvejic E;Lloyd AR;Vollmer-Conna U, 2016, 'Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions', Comprehensive Psychiatry, vol. 66, pp. 166 - 175, http://dx.doi.org/10.1016/j.comppsych.2016.02.002
  33. Hopper, B.; Cameron, B.; Li, H.; Graves, S.; Stenos, J.; Hickie, I.; Wakefield, D.; Vollmer-Conna, U.; Lloyd, A.R. (October 2016). "The natural history of acute Q fever: a prospective Australian cohort". QJM. 109 (10): 661–668. doi:10.1093/qjmed/hcw041. ISSN 1460-2725.
  34. Roerink ME, Buckland M, Lloyd AR, van der Meer JWM. (2017) Cytokine signature in chronic fatigue syndrome. Proc Natl Acad Sci U S A. 2017 Nov 7;114(45):E9435. doi: 10.1073/pnas.1714011114.
  35. Cvejic, Erin; Sandler, Carolina X.; Keech, Andrew; Barry, Benjamin K.; Lloyd, Andrew R.; Vollmer-Conna, Uté (December 2017). "Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome". Journal of Psychosomatic Research. 103: 91–94. doi:10.1016/j.jpsychores.2017.10.010.
  36. Macnamara, Claire L.; Cvejic, Erin; Parker, Gordon B.; Lloyd, Andrew R.; Lee, Gina; Beilharz, Jessica E.; Vollmer-Conna, Ute (2018). "Personalised relaxation practice to improve sleep and functioning in patients with chronic fatigue syndrome and depression: study protocol for a randomised controlled trial". Trials. 19: 371. doi:10.1186/s13063-018-2763-8.
  37. Katz, Ben Z; Collin, Simon M; Murphy, Gabrielle; Moss-Morris, Rona; Wyller, Vegard Bruun; Wensaas, Knut-Arne; Hautvast, Jeannine L.A.; Bleeker-Rovers, Chantal P; Vollmer-Conna, Uté; Buchwald, Dedra; Taylor, Renée; Little, Paul; Crawley, Esther; White, Peter D; Lloyd, Andrew (April 3, 2018). "The international collaborative on fatigue following infection (COFFI)". Fatigue: Biomedicine, Health & Behavior. 6 (2): 106–121. doi:10.1080/21641846.2018.1426086. ISSN 2164-1846. PMID 30666281.
  38. Fatt, Scott J.; Cvejic, Erin; Lloyd, Andrew R.; Vollmer-Conna, Ute; Beilharz, Jessica Elise (February 2019). "The Invisible Burden of Chronic Fatigue in the Community: a Narrative Review". Current Rheumatology Reports. 21 (2). doi:10.1007/s11926-019-0804-2. ISSN 1523-3774.
  39. https://www.actionforme.org.uk/uploads/pdfs/cmrc-2014-conference-report-final.pdf