Results: ETV treatment led to significant histological improvements and improved IFS in 96% (55/57) and 88% (50/57) of patients respectively. Of 10 patients with baseline fibrosis/cirrhosis (IFS 4), all demonstrated 1-point improvement in IFS (median change of -3). Conclusions: LiPA accurately detects the complex quasispecies nature of HBV and can help unravel the dynamics of emerging HBV resistance during treatment with different antiviral drugs. Like its predecessor, it is useful for the monitoring and early detection of drug resistance.