R enrolment, and larger benefits may have been observed in individuals who do not realize the support of disclosing. Confidentiality and disclosure are important considerations for the scale-up of text message interventions [29]. High levels of satisfaction have been documented in other text message trials, particularly in those which offer two way communication [8,30]. While the 
majority of participants in our trial were satisfied with the text messages, a considerable number did not want the intervention to continue. A study conducted prior to this trial reported that patients would like to receive messages with a wide variety of characteristics in terms of timing, content and source [17]. Some participants might not have wanted to continue if the messages weren’t tailored to their needs. Yet, more than 80 would recommend it to their friends. Further research is needed on how best to tailor text messages. It is unclear whether the content of the message played a role in the outcomes, as other trials with no motivational component have reported improvements in adherence [8,9]. The ancillary analyses reported above need to be considered as secondary and MedChemExpress 548-04-9 therefore interpreted with caution in the light of our main findings.Text Messages for Adherence in HIVIn conclusion, motivational text messages did not significantly improve adherence to ART among treatment experienced patients in Cameroon after 6 months. MK-8931 biological activity Although interactive SMS associated with access to health advice has demonstrated to be effective in at least one large clinical trial [8], and is reflected in current guidelines [31] more work needs to be done to determine how motivational content can be delivered by SMS alone. Text messages may come with a small risk of disclosure of status. Further trials are critical to determine what interventions should be taken to scale.(DOC)AcknowledgmentsWe acknowledge the support of the CIHR Canadian HIV Trials Network (CTN) the Centre for the Development of Best Practices in Health (CDBPH) and the Yaounde Central Hospital Accredited Treatment ?Centre (YCH ATC).Author ContributionsConceived and designed the experiments: LM LT RTL POZ EJM. 23727046 Performed the experiments: LM LT CK POZ. Analyzed the data: LM LT LD MS. Contributed reagents/materials/analysis tools: LM LT. Wrote the paper: LM LT POZ MS RTL EJM LD MS.Supporting InformationProtocol S1 Research Protocol.(PDF)Checklist SCONSORT checklist.
Hepatic fibrosis, the common response associated with almost of all chronic hepatitis B virus (HBV) infection, ultimately leads to cirrhosis [1]. With great advancements in the antiviral therapy used for the treatment of chronic virus hepatitis, the accurate assessment of liver fibrosis is a vital need for successful individualized management. Current guidelines recommend antiviral therapy in chronic hepatitis B patients with significant fibrosis ( 2), 15755315 whether or not ALT is abnormal [2]. Moreover, the significant fibrosis correlated strongly with poor clinical outcomes, compared with mild fibrosis [3]. Lack of accurate, reproducible and easily applied methods for fibrosis assessment is the major limitation in the clinical management. The current `gold standard’ for liver fibrosis detection is liver biopsy [4]. Liver biopsy can provide physicians useful clinical information, such as appropriate time to start antiviral therapy, predicting the response to treatment, assessing the natural course of hepatitis, and estimating prognosis of hepatitis. Although ac.R enrolment, and larger benefits may have been observed in individuals who do not realize the support of disclosing. Confidentiality and disclosure are important considerations for the scale-up of text message interventions [29]. High levels of satisfaction have been documented in other text message trials, particularly in those which offer two way communication [8,30]. While the majority of participants in our trial were satisfied with the text messages, a considerable number did not want the intervention to continue. A study conducted prior to this trial reported that patients would like to receive messages with a wide variety of characteristics in terms of timing, content and source [17]. Some participants might not have wanted to continue if the messages weren’t tailored to their needs. Yet, more than 80 would recommend it to their friends. Further research is needed on how best to tailor text messages. It is unclear whether the content of the message played a role in the outcomes, as other trials with no motivational component have reported improvements in adherence [8,9]. The ancillary analyses reported above need to be considered as secondary and therefore interpreted with caution in the light of our main findings.Text Messages for Adherence in HIVIn conclusion, motivational text messages did not significantly improve adherence to ART among treatment experienced patients in Cameroon after 6 
months. Although interactive SMS associated with access to health advice has demonstrated to be effective in at least one large clinical trial [8], and is reflected in current guidelines [31] more work needs to be done to determine how motivational content can be delivered by SMS alone. Text messages may come with a small risk of disclosure of status. Further trials are critical to determine what interventions should be taken to scale.(DOC)AcknowledgmentsWe acknowledge the support of the CIHR Canadian HIV Trials Network (CTN) the Centre for the Development of Best Practices in Health (CDBPH) and the Yaounde Central Hospital Accredited Treatment ?Centre (YCH ATC).Author ContributionsConceived and designed the experiments: LM LT RTL POZ EJM. 23727046 Performed the experiments: LM LT CK POZ. Analyzed the data: LM LT LD MS. Contributed reagents/materials/analysis tools: LM LT. Wrote the paper: LM LT POZ MS RTL EJM LD MS.Supporting InformationProtocol S1 Research Protocol.(PDF)Checklist SCONSORT checklist.
Hepatic fibrosis, the common response associated with almost of all chronic hepatitis B virus (HBV) infection, ultimately leads to cirrhosis [1]. With great advancements in the antiviral therapy used for the treatment of chronic virus hepatitis, the accurate assessment of liver fibrosis is a vital need for successful individualized management. Current guidelines recommend antiviral therapy in chronic hepatitis B patients with significant fibrosis ( 2), 15755315 whether or not ALT is abnormal [2]. Moreover, the significant fibrosis correlated strongly with poor clinical outcomes, compared with mild fibrosis [3]. Lack of accurate, reproducible and easily applied methods for fibrosis assessment is the major limitation in the clinical management. The current `gold standard’ for liver fibrosis detection is liver biopsy [4]. Liver biopsy can provide physicians useful clinical information, such as appropriate time to start antiviral therapy, predicting the response to treatment, assessing the natural course of hepatitis, and estimating prognosis of hepatitis. Although ac.