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Chronic hepatitis C infection and sex hormone levels: effect of disease severity and recombinant interferon-α therapy

Authors

  • H. V. Nguyen,

    1. Departments of 1Endocrinology, 2Gastroenterology, 3Infectious Diseases and 5Biochemistry, Fremantle Hospital, Fremantle and 4School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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  • 1 L. C. Mollison,

    1. Departments of 1Endocrinology, 2Gastroenterology, 3Infectious Diseases and 5Biochemistry, Fremantle Hospital, Fremantle and 4School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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  • 2,3,4 T. W. Taylor,

    1. Departments of 1Endocrinology, 2Gastroenterology, 3Infectious Diseases and 5Biochemistry, Fremantle Hospital, Fremantle and 4School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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  • 5 S. A. P. Chubb,

    1. Departments of 1Endocrinology, 2Gastroenterology, 3Infectious Diseases and 5Biochemistry, Fremantle Hospital, Fremantle and 4School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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  • and 5 B. B. Yeap 1,4

    Corresponding author
    1. Departments of 1Endocrinology, 2Gastroenterology, 3Infectious Diseases and 5Biochemistry, Fremantle Hospital, Fremantle and 4School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
      Bu B. Yeap, School of Medicine and Pharmacology, University of Western Australia, Level 2, T-Block, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia.
      Email: byeap@cyllene.uwa.edu.au
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  • Funding: B.B.Y. is a recipient of a Viertel Clinical Investigator Award from the Sylvia and Charles Viertel Charitable Foundation, New South Wales, Australia.

    Potential conflicts of interest: None

Bu B. Yeap, School of Medicine and Pharmacology, University of Western Australia, Level 2, T-Block, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia.
Email: byeap@cyllene.uwa.edu.au

Abstract

Background: We aimed to investigate the associations between androgen status and markers of liver disease severity and to determine the effect of interferon-α (IFN-α) treatment on sex hormone levels in the context of hepatitis C infection.

Methods: We audited liver biopsy and sex hormone data from 35 men with chronic hepatitis C and a separate group of 11 men with hepatitis C who received IFN-α treatment at Fremantle Hospital.

Results: We found that men with low fibrosis scores (0–2) on the modified Knodell histological activity index were more likely to have lower sex hormone–binding globulin (SHBG) levels (38.2 ± 13.2 vs 66.6 ± 43.3 nmol/L, P < 0.001) and higher free testosterone levels (380.4 ± 102.0 vs 255.9 ±83.0 pmol/L, P = 0.01) than those with higher fibrosis scores (3–6). SHBG directly correlated with fibrosis scores (r = 0.37, P = 0.032). Free testosterone levels inversely correlated with liver fibrosis scores (r = −0.43, P = 0.011). A transient reduction in total testosterone of 5.7 ± 4.2 nmol/L (P = 0.014) occurred within the first 6 months of IFN-α therapy although free testosterone was unaffected.

Conclusion: More severe liver disease was associated with lower free testosterone and higher SHBG. IFN-α therapy reduced total testosterone but not to hypogonadal levels, with no decline in free testosterone. These data suggest that liver disease in hepatitis C infection modulates androgen status indirectly via increased SHBG. Screening for androgen deficiency in the context of hepatitis C infection should selectively target men with more severe liver disease or documented higher grade fibrosis.

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