Transient elastography is a feasible screening tool for cirrhosis among drug users. Transient elastography identifies severe liver fibrosis in a significant proportion of drug users with hepatitis C infections but management should not be based on a single elevated liver stiffness measurement.

The aims of this study were to determine the current prevalence of viral hepatitis and HIV among drug users, and to compare this prevalence with previous findings in the same geographical region. Cross‐sectional surveys of drug users attending treatment centers on the island of Funen with approximately 500,000 inhabitants were administered in 1996 and 2007. The 2007 prevalence estimates were: anti‐HBc 50.2%, HBsAg 0.9%, anti‐HCV 66.8%, HCV‐RNA 40%, and anti‐HIV 1.1%. The corresponding 1996 prevalence values were: anti‐HBc 70% (P < 0.0001), HBsAg 9.8% (P < 0.0001), anti‐HCV 82.8% (P < 0.0001), HCV‐RNA 56.3% (P = 0.002), and anti‐HIV 1% (P = 1). The 2007 prevalence of viral hepatitis decreased due to the increasing proportion of non‐injectors. Among injectors, the prevalence remained unchanged except for a significant decrease in HBsAg. The 2007 prevalence of ongoing HBV infection among infected (HBsAg/anti‐HBc proportion) was the lowest that to our knowledge has been reported among drug‐users. Vaccination coverage among susceptible persons tested in 2007 was 24%, compared to 0.7% in 1996. Therefore, despite an unchanged prevalence of anti‐HBc among injecting drug users, a highly significant drop in HBsAg prevalence was seen during the last decade. This observation may be linked causally to an increase in hepatitis B vaccination of the susceptible population. Our findings suggest that even incomplete vaccination, without persistent protective anti‐HBs levels, may induce an immune memory sufficient to prevent chronic infection upon transmission. J. Med. Virol. 82:1635–1639, 2010. 2010 Wiley‐Liss, Inc.

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The protective effect of primed CD4+ T lymphocytes against a lethal dose of 108 viable Salmonella typhimurium was studied in Lewis rats. Primed CD4+ T lymphocytes were obtained by inoculating Lewis rats with a non‐lethal dose of 106 viable S. typhimurium. Four weeks after the infection, spleen CD4+ T lymphocytes were separated using magnetic microspheres coated with an antibody against the CD4 molecule (W3/25). Subsequent sorting into activated and non‐activated subpopulations using the p55 α‐chain of the interleukin‐2 receptor (CD25) as an activation marker was performed by a fluorescence‐activated cell sorter. Untreated Lewis rats were injected with 104 different primed CD4+ T‐cell populations 24 h prior to the lethal dose of 108 viable S. typhimurium. Blood samples were drawn from the orbital plexus 1, 2, 3, and 4 weeks after the infection, and analysed for specific IgM and IgG antibodies. Cell sorting revealed that 2/3 of the primed CD4+ T lymphocytes expressed high levels of CD25. Cell transfer revealed that both CD25high and CD25low expression populations could induce immunity against a lethal dose of S. typhimurium, whilst antibody analysis revealed that antibody levels were not correlated with protection against S. typhimurium infections, although it showed that a higher and more persistent level of specific IgG antibodies was produced in animals receiving the CD4+CD25high fraction. It is concluded that 104 primed CD4+ T lymphocytes can induce immunity in animals challenged with a lethal dose of S. typhimurium and that antibodies do not seem to be correlated with the immunity induced. The CD4+CD25high fraction was, however, associated with a higher and more persistent level of specific IgG antibodies.