Results: 3077 and 3100 ions were detected in the initial screening experiments. By statistical analysis of 148 feature variables were significantly different between

the different groups. 23 important differential metabolites were found and were confirmed and related with pathophysiological process of hepatitis. The potential biomarkers in the hepatocyte damage and repair, energy consumption, fatty acid biosynthesis, bile acid biosynthesi and inflammation play important roles in progression, and they also can be used for clinical staging of indicators are not clear without liver biopsy. Such as glycocholic acid, Taurochenodeoxycholic acid, Taurocholic acid, 3-Oxodecanoic acid, biliverdin, lysophosphatidylethanolamines and lysophosphatidylcholines could be used as clinical indicators

Selumetinib nmr of staging without liver biopsy, which could provide good sensitivity and specificity for the diagnosis of immune active CHB. Lysophosphatidylcholines could be the potential biomarkers for immune tolerant and oleamide could be the potential biomarker of inactive carrier. Conclusion: This metabonomic approach CP-690550 cost may provide insight into discovery and identification of new diagnostic biomarkers for immune active phase in chronic hepatitis B and for guidance of antiviral treatment is of great significance. Drug treatments not only improves efficiency, and avoid unnecessary treatment and associated adverse reactions occur, which will open up a new era of individualized treatment of chronic hepatitis B. Key Word(s): 1. HBV; 2. metabonomics; 3. immune active stage; 4. biomarker; Presenting SB-3CT Author: RINKESHKUMAR BANSAL Additional Authors: VERONICA ARORA, VINITSANJAY

SHAH, PRAVEEN SHARMA, PANKAJ TYAGI, ASHISH KUMAR, VIKAS SINGLA, NARESH BANSAL, ANIL ARORA Corresponding Author: RINKESHKUMAR BANSAL Affiliations: Sir GangaRam Hospital Objective: Liver stiffness (LS) measurement using FibroScan is a reproducible and accurate technique for assessment of fibrosis and portal hypertension. Often it is difficult to differentiate severe acute viral hepatitis (AVH) from patients with acute on chronic liver failure (ACLF) at admission. Aim is to determine utility of LS measurement in differentiating patients from severe AVH and ACLF at admission Methods: A total of 90 patients with severe AVH (serum bilirubin&gt5 and INR&gt1.5) and ACLF as per APASL guidelines of varying etiologies were recruited prospectively. LS and biochemical tests were performed at admission and liver biopsy was done if needed. Results: The mean age of the patients (78 men and 12 women) was 37.7±14.9 years. The etiology of acute hepatitis (n=45) included (HAV,n=12, HEV,n=18, drug induced, n= 3, HBV,n= 3 and unknown, n= 9).Similarly etiology of ACLF(n=45) were HBV with severe reactivation, n=10,Alcoholic with alcoholic hepatitis, n=24, acute viral hepatitis on cryptogenic cirrhosis, n=11.