Results: There were 34 patients with NCPF (M:F 1:1.8) and 30 patients with EHPVO (M: F ratio 1.6:1). The mean age was 24.9 yrs and

41.2 yrs respectively. During follow up, 20 out of 34 and 16 out of 30 patients with NCPF and EHPVO respectively had no progression Fulvestrant clinical trial of disease. 14 patients with NCPF progressed to cirrhosis over a mean period of 5.21 years. Eight patients developed ascites and required diuretics. 14 patients with EHPVO progressed to NCPF over the mean period of 8.6 years, 12 patients further progressed to cirrhosis over a mean period of 5.1 years. Overall 40% of patients with EHPVO progressed to cirrhosis over a mean period of 13.7 years. Conclusion: INCPH is a spectrum wherein EHPVO progresses to NCPF and further to cirrhosis over a period of 13.7 years at least in a proportion of patients. Conversely, identifying these changes may suggest to the clinicians the need to work-up a patient for portal hypertension. Key Word(s): 1. INCPH; 2. NCPF; 3. EHPVO; 4. Cirrhosis; Presenting Author: WEI HOU Additional Authors: CHENYANG DAI, HANGYU PEI, SRT1720 chemical structure WUKUI CAO, YUQIANG MI, JIMING YANG, WEI LU

Corresponding Author: WEI HOU Affiliations: Tianjin Second People’s Hospital and Tianjin Institute of Hepatology Objective: The aim of this study was to investigate the characteristics of tyrosine-methionine-aspartate-aspartate (YMDD) mutation and analyze the codon usage pattern of YMDD variants in patients with lamivudine (LAM)-resistant chronic hepatitis B (CHB). Methods: 514 CHB inpatients and outpatients from our hospital with confirmed genotypic resistance to LAM were enrolled in this study between Jan 2008 and Oct 2012. The YMDD motif of these HBV isolates were analyzed Amobarbital using a pyrosequencing method. Results: The baseline YMDD mutation patterns were as follows: rtM204I (298, 57.98%), rtM204V (168, 32.68%), and rtM204I+ rtM204V (48, 9.34%). For rtM204I mutation (I = AAT, ATC or ATA), I/ATT (84.78%) >I/ATC (8.97%) >I/ATA (6.25%). Most of the I/ATC (90.91%), I/ATT (70.34%) and I/ATA (65.21%) variants were completely mutated. For rtM204V mutation (V = GTG, GTT, GTA or GTC), V/GTG

(80.54%) >V/GTT (16.79%) >V/GTA (1.53%) >V/GTC (1.14%). More than half of V/GTG (53.55%) variants were completely mutated. However, V/GTA (100%), V/GTT (90.91%) and V/GTC (66.67%) variants were always mixed with M/ATG wide-type isolates. Conclusion: We firstly show the synonymous codon usage pattern of YMDD variants in HBV isolates. The synonymous codons of YMDD variants are not chosen equally and randomly. I/ATT and V/GTG are predominant for rtM204I and rtM204V mutation, respectively. A further investigation of the mutation pressure with translation selection on codon usage might shed a new light on understanding the evolutionary trends of HBV and host adaptive response, which might assist control this disease. Key Word(s): 1. chronic hepatitis B; 2. lamivudine; 3. YMDD; 4.