The propagation of these waves through the liver is directly correlated to the degree of liver stiffness. The results are instantaneously received as a single, quantitative parameter of liver stiffness measurement (LSM, reported in kPa). Each transient elastography scan takes ten liver stiffness measurements in rapid succession www.selleckchem.com/products/Rapamycin.html over several seconds. The median of the ten measurements is reported as the final liver stiffness measurement. The procedure is non-invasive, painless, has no side effects, and requires only a few minutes to perform. The device requires minimal training and does not need to be performed by advanced medical personnel. In this study a conservative liver stiffness measurement cutoff of ��9.

3 kPa, from a validation study in persons of predominantly African descent, was used to define significant fibrosis equivalent to METAVIR fibrosis stage 2 (portal fibrosis with few septa) or greater [15]. Two study nurses at the Rakai Health Science Program study site conducted all transient elastography scans after receiving certification from the manufacturer. According to manufacturer recommendations, scans with high variability��defined as an interquartile range greater than 30% of the median LSM value from an individual examination��were not considered valid and were excluded from the analysis. Participants with invalid scans on an initial attempt were repositioned and rescanned up to 4 times to achieve a valid scan. Statistics Baseline demographic, behavioral and clinical characteristics were compared by HIV status.

Differences in continuous variables were assessed using t-tests and Wilcoxon-Mann-Whitney tests. Categorical variables were compared using Pearson’s chi squared test. The primary outcome measure was liver fibrosis. Because odds ratios may overestimate the magnitude of association between variables if the outcome of interest is common, adjusted prevalence risk ratios (adjPRR) with 95% confidence intervals (95% CI) were estimated using modified Poisson regression [16]. The multivariable models adjusted for HIV, gender, occupation in the fishing industry, chronic hepatitis B infection (positive hepatitis B surface antigen), and drinking ��1.25 liters per week of liquor, as these risk factors were associated with liver disease in previous analysis of this study population [9].

Age was included in all models and nadir CD4 cell count and ART status were included in models restricted to HIV- infected participants for reasons of biologic plausibility. STATA version 11.0 (STATA Corp, College Station, TX) was used for statistical analysis. Results Baseline Characteristics The HIV-infected and uninfected groups each had 67% females (see table 1). The median GSK-3 age of 38 years in the HIV-infected group was close to the median age of 37 years in the HIV- uninfected group (p=0.025). Only 2% of both HIV-infected and uninfected participants were heavy liquor drinkers (p=0.65).