S.M. Wu 1 , X. Zhou 2 1 Wuhan Medical Treatment Center, 2 Center for Gene Diagnosis, Zhongnan Hospital, Wuhan University, China E-selectin is revealed to facilitate leukocyte adhension to the endothelium and migration into inflamed tissue in inflammatory diseases. Chronic hepatitis B virus infection is regarded as a chronic inflammatory process. To examine the possible involvement of E-selectin in the etiology of chronic HBV infection, we analyzed two polymorphisms of E-selectin and determined the plasma souble E-selectin levels in patients with chronic HBV infection and controls. The frequency of C allele of the A561C polymorphism was significantly increased in patients with LC campared with controls. No significant positive association was observed between the G98T polymorphism and chronic HBV infection. But in patients with LC, divided according to the Child-Pugh classification, the frequency of T allele was of significant difference between Child'class A and class B plus C. Plasma Levels of soluble E-selectin were significantly increased in patients with chronic hepatitis and liver cirrhosiscompared with controls. In the liver cirrhosis group, levels of sE-selectin were significantly decreased from Child' class A to class C. In each group, patients with C allele of the A561C polymorphism showed higher soluble E-selectin levels than those with A allele. This is the first report describing the association between E-selectin polymorphisms and HBV-related hepatic fibrosis. Our data showed the A561C polymorphism of E-selectin gene is associated with disease progression in patients with HBV infection and controls the expression of plasma soluble levels, the G98T polymorphism may be related to fibrotic severity in patients with liver cirhosis. Background: Chronic hepatitis B (CHB) patients with high serum HBV-DNA and normal serum alanine aminotransferase (ALT) levels might be considered for treatment if histopathological findings show fibrosis stage 2 or more. However, to our knowledge there is no recommendation with regard to the therapeutic agents for this group of patients. Objective: This study was aimed to evaluate the efficacy of nucleoside analogues (entecavir or telbivudine) in treating chronic hepatitis B patients with high serum HBV-DNA and normal serum ALT levels. Patients and method: This was an open-label study in CHB patients with high level serum HBV-DNA levels between January 2007 and October 2008. Patients were included if they showed normal serum alanine aminotransferase (ALT) level at two measurements within a 3-month interval and had fibrosis stage > 2 on liver biopsy specimens. Patients were treated with entecavir 0.5 mg/day or telbivudine 600 mg/day. The primary endpoint was the reduction or undetectable of serum HBV-DNA at 24 week and 48 week of treatment, while the secondary endpoint was hepatitis B e antigen (HBeAg) seroconversion. Results: During a 2-year period, 37 CHB patients with high level serum HBV-DNA with normal ALT two times with 3 months interval underwent a liver biopsy. Twenty-eight (75.7%) of 37 pts showed fibrosis stage 2 on histological findings (Metavir score). Twelve of these 28 patients received nucleoside analogues, 7 (58.3%) of them were men. Patients' median age was 42 (range: 24-52) years. There were 5 patients with stage-2, 6 patients with stage-3 and 1 patient with stage-4 fibrosis. Eleven (91.7%) patients had genotype B virus. At baseline, the mean serum ALT level was 32 + 11.8 U/L and mean HBV-DNA level was 2.48 x 10 6 IU/mL, ranging from 1.23 x 10 3 to 2.4 x 10 7 IU/mL. Six patients received entecavir and the other six received telbivudine therapy. Undetectable HBV-DNA was achieved by 9 (75.0%) patients at week-24 and 2 (16.7%) patients at week-48 of treatment. One patient who had the highest HBV-DNA level had viral load reduction to 1.6 x 10 4 IU/mL at week-48 of treatment. Two out of 5 patients with positive HBeAg achieved HBeAg seroconversion at week-48 of treatment. Conclusion: This preliminary study has shown that nucleoside analogues might be considered in the treatment for chronic hepatitis B patients with high serum HBV-DNA and normal serum aminotransferases levels.