The Effect of Anti-HBV Drugs on Albumin and Bilirubin Levels, and Platelet Count H. Yoshida 1 , H. Taniguchi 1 , R. Nagano 1 , K. Sakitani 1 , E. Seki 1 , T. Serizawa 1 , Y. Ito 1 , H. Mizuno 1 , Y. Mitsuno 1 , R. Nakata 1 , M. Omata 2 1 Japanese Red Cross Medical Center, 2 University of Tokyo, Japan Background/Aim: We assessed the efficacy of anti-HBV drugs on the liver function. Methods: Patients with HBV-related disease followed at our center between 2005 and 2007 were enrolled. Lamivudine (100mg), lamivudine (100mg) +adefovir (10mg), or entecavir (0.5mg) was administered to the patients with detectable HBV DNA and elevated ALT. Liver function (ALT, ALB, and T.Bil) and platelet count were observed. ALT, ALB, T.Bil, and platelet count of treated group at pretreatment, year 1, and year 2 were compared with untreated group. Results: Eighty six patients with positive HBsAg were enrolled between Jan 2005 and Dec 2007. Seven patients (2 acute infection, 1 overlap infection with HCV, 7 lost of follow up) were excluded. In total 76 patients were followed up for a median follow up of 26 (range 2-39) months. Of 76 patients, 32 received anti-viral treatment. Twenty one patients were treated with lamivudine, 4 with lamivudine+adefovir, and 7 with entecavir. The mean of levels of pre-treatment-year1-year2 were ALT:129-37-43 (U/L), ALB:4.0-4.4-4.4 (g/dl), T.Bil:1.0-0.8-0.7 (mg/dl), and Plt:14.3-15.4-16.0 (x10 4 mcl) respectively. Markers of untreated group (n=44) (at baseline-year1-year2) were ALT:33-40-35 (U/L), , T. Bil:0.8-0.8-0.9 (mg/dl), and Plt:18.7-18.0-18.5 (x10 4 mcl) respectively. Although all of four markers in treated group were significantly worse than untreated group at baseline, all of four markers did not showed significant difference from untreated group at year2. Conclusion: Treatment with anti-HBV drugs showed the efficacy not only transaminase levels, but also on albumin, bilirubin, and platelet count improvement-improvement of "hepatic reserve" which is valuable for prevention of cirrhosis. Background: Currently, HBeAg-negative chronic hepatitis B(CHB) is increasing. But there are still controversial on the treatment of HBeAg-negative CHB with ALT 2×ULN. We have investigated the clinical efficacy of nucleotide analogues(NAs) in the treatment of HBeAg-negative CHB with ALT 2×ULN. Methods: The data of patients who were treated by NAs for more than 2 years and with ALT 1 2×ULN (n=87) , ALT 1×ULN(n=43) and ALT 2×ULN(n=88) were collected, and 12W and 24W virologic response, 48W and 96W complete response, virologic breakthrough and clinical resistance were analyzed. Results: Compared with the base line, HBV DNA level in all three groups were significantly decreased (P 0.01), and there was no significant difference between ALT 1 2×ULN group and ALT 2×ULN group. The viral load was significant decreased in ALT 1×ULN group at 12W, 24W and 36W (P<0.05). Virologic response at 12W and 24W complete response at 48W and 96W was 71.3%, 82.8% , 82.8% and 86.2% respectively in ALT 1 2×ULN group and was 51.2%, 60.5%, 65.1% and 74.4% respectively in ALT 1×ULN group. There was no significant difference between ALT 1 2×ULN group and ALT 2×ULN group. Virologic response at 12W and 24W and complete response at 48W were significant decreased (P<0.05) in ALT 1×ULN group. There was no significant difference among the three groups in virologic breakthrough and clinical resistance. Conclusion: HBV replication can be satisfactory inhibited by NAs in HBeAg-negative CHB patients with ALT 2×ULN, which suggests that in these patients the indication of ALT is different from HBeAg-positive patients.