SUMMARYBackground: Non-compliance with maintenance mesalazine therapy may be a risk factor for relapse in inflammatory bowel disease, but the prevalence and determinants of non-compliance are unknown. Aim: To study the prevalence and determinants of noncompliance in patients with inflammatory bowel disease. Methods: Out-patients receiving delayed-release mesalazine were studied. Compliance was determined by direct enquiry and by analysis of urine samples for 5-aminosalicylic acid/N-acetyl-5-aminosalicylic acid. Potential determinants of compliance were assessed. Results: Ninety-eight patients were studied. Forty-two patients (43%) reported taking < 80% of their prescribed dose. Logistic regression revealed the independent predictors of non-compliance to be three-times daily dosing [odds ratio (OR), 3.1; 95% confidence

Large increases in the incidence of GI-NETs were observed, along with changes in anatomical distribution. Such changes may partly reflect changes in classification or improved detection through the increased use of endoscopy and imaging techniques. In view of the magnitude of these changes, particularly for gastric tumors, further studies to examine the underlying etiology of these changes are urgently indicated.

Intestinal CD4+ T cells are essential mediators of immune homeostasis and inflammation. Multiple subsets of CD4+ T cells have been described in the intestine, which represents an important site for the generation and regulation of cells involved in immune responses both within and outside of the gastrointestinal tract. Recent advances have furthered our understanding of the biology of such cells in the intestine. Appreciation of the functional roles for effector and regulatory populations in health and disease has revealed potential translational targets for the treatment of intestinal diseases, including inflammatory bowel disease. Furthermore, the role of dietary and microbiota-derived factors in shaping the intestinal CD4+ T-cell compartment is becoming increasingly understood. Here, we review recent advances in understanding the multifaceted roles of CD4+ T cells in intestinal immunity.

Summary Background  Anti‐Tumour necrosis factor (TNF) therapy is now well established in the treatment of inflammatory bowel disease and the risk of opportunistic infection is recognized. However, specific considerations regarding screening, detection, prevention and treatment of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease are not widely adopted in practice. Aim  To provide a detailed and comprehensive review of the relevance of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease. Methods  Literature search was conducted using Medline, Pubmed and Embase using the terms viral infection, hepatitis, herpes, CMV, EBV, HPV, anti‐TNF, infliximab, adalimumab, certolizumab pegol and etanercept. Hepatitis B and C and HIV had the largest literature associated and these have been summarized in Tables. Results  Particular risks are associated with the use of anti‐TNF drugs in patients with hepatitis B infection, in whom reactivation is common unless anti‐viral prophylaxis is used. Reactivation of herpes zoster is the most common viral problem associated with anti‐TNF treatment, and may be particularly severe. Primary varicella infection may present with atypical features in patients on anti‐TNF. Conclusion  Appreciation of risks of chronic viral disease associated with anti‐TNF therapy may permit early recognition, prophylaxis and treatment.

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