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Multiple sclerosis and the risk of infection: Association of British Neurologists consensus guideline
  1. Marija Cauchi1,
  2. Mark Willis1,
  3. Angela Andrews2,
  4. Matthijs Backx3,
  5. Wallace Brownlee4,
  6. Helen L Ford5,
  7. Bruno Gran6,7,
  8. Stephen Jolles8,
  9. Sian Price9,
  10. Waqar Rashid10,
  11. Klaus Schmierer11,12,
  12. Emma C Tallantyre1
  1. 1 Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, University Hospital of Wales, Cardiff, UK
  2. 2 Pharmacy Neurosciences Directorate, University Hospital of Wales, Cardiff, UK
  3. 3 Infectious Diseases, University Hospital of Wales and Department of Microbiology, Public Health Wales, Cardiff, UK
  4. 4 Queen Square MS Centre, University College London Institute of Neurology, Queen Square Multiple Sclerosis Centre, London, UK
  5. 5 Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, UK
  6. 6 Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  7. 7 Mental Health and Clinical Neuroscience Academic Unit, University of Nottingham School of Medicine, Nottingham, UK
  8. 8 Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
  9. 9 Department of Neuroscience, University of Sheffield, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  10. 10 Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
  11. 11 The Blizard Institute (Neuroscience, Surgery & Trauma), Queen Mary University of London Faculty of Medicine and Dentistry, London, UK
  12. 12 Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Marija Cauchi, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, University Hospital of Wales, Cardiff CF10 3AT, UK; cauchim1{at}


Infection in people with multiple sclerosis (MS) is of major concern, particularly for those receiving disease-modifying therapies. This article explores the risk of infection in people with MS and provides guidance—developed by Delphi consensus by specialists involved in their management—on how to screen for, prevent and manage infection in this population.

  • multiple sclerosis
  • infectious diseases

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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  • Twitter @helenlouiseford, @KlausSchmierer

  • Contributors MC and MW: writing, original draft, review and editing, development of Delphi statements. ECT: conceptualisation, supervision, writing-review and editing, development of delphi statements. AA, MB, WB, HLF, BG, SJ, WR and KS: discussed delphi statements. All authors participated in the Delphi process, revised the manuscript and approved the final version for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The Association of British Neurologists (ABN) endorses, but does not mandate use of this guideline, and suggests that use of the guideline should not override the clinician’s judgement.

  • Competing interests WB has received honoraria from Biogen, Celgene, Merck, Mylan, Novartis, Roche and Sanofi. HLF has received support from the Health Technology Assessment Programme (NIHR) and the UK MS Society. In the past 3 years, HLF has been a local principal investigator for trials in MS funded by Novartis, Roche and Biogen Idec and has taken part in advisory boards and consultancy for Merck, Teva, Biogen, and Novartis. SJ reports Advisory Board, Speaker, Conference, Drug Safety Monitoring Board, and project support from CSL Behring, Takeda, BioCryst Pharmaceuticals, Swedish Orphan Biovitrum, Biotest, Binding Site, LFB, Octapharma, Grifols, UCB Pharma, Sanofi, Pharming, Weatherden and Zarodex Therapeutics Limited. SJ is a member of the IPOPI SAFE Taskforce and COVIC19 Trial Group. BG has received personal compensation for consultancy from Merck, Roche, Biogen, Teva UK, and GW Pharma. He has received unrestricted research grants from Biogen Idec, Merck, Bayer Healthcare, Teva UK, Novartis, and Genzyme; and support for the attendance of clinical and research conferences from Biogen, Merck, Bayer Healthcare, Teva UK, Novartis, Genzyme, and CelGene. KS has received research support from Biogen, Merck KGaA, and Novartis, speaking honoraria from, and/or served in an advisory role for, Amgen, Biogen, EMD Serono, Merck KGaA, Novartis, Roche, Sanofi-Genzyme, and Teva; and remuneration for teaching activities from AcadeMe, Medscape and the Neurology Academy.

  • Provenance and peer review Not commissioned; externally peer reviewed by Alasdair Coles, Cambridge, UK and Neil Scolding, Bristol, UK.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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