Twenty-five samples negative or indeterminate by nPCR were positive by RT. Similarly, 17 samples indeterminate by nPCR but RT negative were either truly negative by repeat nPCR testing (1 1/17) or had a viral load below the limit of quantification. OBI was detected in 8 (0.8%) of the HBsAg-negative specimens using the criteria of at least two RT targets positive; however, 55 (5.5%) samples were positive by at least

one RT target, indicating a large discrepancy in reported OBI if the RT protocol were not followed. Conclusions: Results of this study suggest that the RT protocol had increased sensitivity, objectivity and reliability compared to the nPCR method. The results also support the present diagnostic criteria for OBI, of at least two target sites, in community-based populations. Disclosures: The following people have nothing to disclose: Carla Osiowy, Anton Andonov, Jamie Borlang, Chris Huynh, Julia Uhanova, GSK-3 signaling pathway Gerald Y. Minuk Introduction: Liver stiffness measurement (LSM) using transient elastography (TE) can grade liver fibrosis non-invasively in chronic hepatitis B (CHB). However, diagnostic cut-offs differ and even ALT-stratified cut-offs have been proposed due to

the confounding effect of ALT on LSM. Only a few small studies examined ALT-stratified cut-offs. Therefore, we sought to 1) develop optimal cut-offs to grade liver fibrosis, and 2) evaluate the diagnostic performance selleck chemical of ALT-stratified cut-offs in CHB patients. Methods: Pregnenolone In this multicenter retrospective study, we enrolled CHB patients with paired liver biopsy and LSM between 2005 and 201 3. Liver biopsies had to be ≥15 mm in length and corresponding LSMs had to be valid (IQR/M ratio ≤0.30, ≥10 valid measurements, and success rate ≥60%). The LSMs were performed

within 3 months of the liver biopsy. We excluded patients with HCC, hepatic decompensation, concomitant liver diseases, liver transplant, and HCV, HDV, HIV co infections. We calculated the AUROCs and net reclassification index (NRI) of non-stratified cut-offs (≥F2 – 7.2 kPa; ≥F3 – 8.1; F4 – 1 1.0) compared to ALT-stratified cut-offs (ALT ≤1 upper limit of normal [ULN]: ≥F2 – 6.0 kPa; ≥F3 – 9.0; F4 – 12.0. ALT <1 ULN: ≥F2 - 7.5 kPa; ≥F3 - 12.0; F4 - 13.4). Results: We analyzed 301 paired liver biopsies and LSMs. The fibrosis stage was F0 in 11.3% (34), F1 in 41.5% (125), F2 in 28.2% (85), F3 in 1 1.6% (35) and F4 in 7.3% (22). We found 219 (73.2%) patients with ALT >1 ULN, 138 (46.2%) with ALT >1.5 ULN, and 95 (31.8%) with ALT >2 ULN. The AUROCs to diagnose ≥F2, ≥F3, F4 were, 0.794, 0.830, 0.879, respectively. We used the maximum sum of sensitivity and specificity to calculate the cut-offs (in kPa): 7.1 for ≥F2, 8.8 for ≥F3, and 11.9 for F4. We observed a significantly higher LSMs in patients with ALT <1 ULN compared to ALT ≤1 ULN within the METAVIR group F1 (p=0.009), F2 (p=0.005), and F3 (p=0.009). However, there were no significant differences between AUROCs of non-stratified vs.