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A VCTE quality assurance programme was established to ensure consistency and accuracy for longitudinal assessment of steatosis (fatty liver) via the controlled attenuation parameter (CAP) and fibrosis via liver stiffness (LS). Demographic, lifestyle factors, anthropometry, clinical and medication history, host genetics, immune markers and hormone levels were collected as part of the WIHS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings to date<\/jats:title><jats:p>At baseline, 737 of 1543 women with CAP measurements had steatosis (CAP \u2265248\u2009dB\/m) and 375 of 1576 women with LS measurements had significant fibrosis (LS \u22657.1\u2009kPa), yielding a prevalence of 48% and 24%, respectively. On multivariable analysis, waist circumference (WC) and insulin resistance were independently associated with higher CAP (17.8\u2009dB\/m per 10\u2009cm (95%\u2009CI:16.2 to 19.5) and 1.2\u2009dB\/m per doubling (95%\u2009CI:0.8 to 1.6), respectively). By contrast, HIV\/HCV seropositivity and HCV seropositivity alone were associated with less steatosis compared with HIV\/HCV-seronegative women, although the latter did not reach statistical significance (\u22129.2\u2009dB\/m (95%\u2009CI:\u201318.2 to \u20130.3) and \u221210.4\u2009dB\/m (95%\u2009CI: \u221223.8 to 3.1), respectively). Factors independently associated with higher LS were age (4.4% per 10 years (95%\u2009CI: 0.4% to 8.4%)), WC (5.0% per 10\u2009cm (95%\u2009CI: 3.3% to 6.6%)), CAP steatosis (0.6% per 10\u2009dB\/m (95%\u2009CI: 0.1% to 1.0%)), HIV\/HCV seropositivity (33% (95% CI: 24% to 44%)) and HCV seropositivity alone (43% (95% CI: 28% to 60%)). Excluding scans that were invalid based on traditional criteria for unreliability did not affect the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Future plans<\/jats:title><jats:p>Enrolled women undergo VCTE at 3-year intervals unless LS is \u22659.5\u2009kPa, indicating advanced fibrosis, in which case VCTE is performed annually. Participants also undergo VCTE every 6 months until 18 months after HCV treatment initiation. 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