The objective of this research is to design a diagnostic test that will allow detection of chronic hepatitis B virus (HBV) patients with early-stage liver inflammation, because detection and treatment of early-stage disease substantially lowers the risk for liver cancer. The test will detect mutations in HBV DNA that arise as a result of the virus attempting to escape detection by the host immune responses that cause the liver inflammation.This test will enhance clinical decision making by increasing the ability of physicians to initiate early treatment for chronic hepatitis B. This will result in improved patient outcomes and reduced healthcare costs associated with screening for and treating liver cancer. It will extend the capability of the New Zealand Hepatitis B Screening Programme to detect and refer patients for treatment. Professor Gane will ensure timely and effective transfer of this knowledge to the screening programme.