Skip to main content
Erschienen in: Journal of Gastroenterology 5/2014

01.05.2014 | Original Article—Liver, Pancreas, and Biliary Tract

Role of serum dehydroepiandrosterone sulfate level on the clearance of chronic hepatitis B virus infection

verfasst von: Jia-Feng Wu, Wen-Yu Tsai, Yi-Ching Tung, Huey-Ling Chen, Yen-Hsuan Ni, Hong-Yuan Hsu, Mei-Hwei Chang

Erschienen in: Journal of Gastroenterology | Ausgabe 5/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

The natural course of chronic hepatitis B virus (HBV) infection and relevant host factors remain unclear. This study aims to investigate the impact of dehydroepiandrosterone sulfate (DHEAS) on the clearance of chronic HBV infection.

Methods

Two hundred and one hepatitis B e antigen (HBeAg)-positive chronic HBV-infected children (101 females) were recruited. Serum DHEAS levels were determined in all subjects at 15 years of age. Serum alanine aminotransferase (ALT) levels, DHEAS levels, HBV seromarkers, genotypes, and viral loads were included for analysis.

Results

Subjects with serum DHEAS levels >3.6 μmol/L at midpuberty had earlier HBeAg seroconversion (median age, 14.7 vs. 18.2 years; HR, 1.9; P = 0.03), and the impact persisted even after adjusting for gender, HBV genotype, peak ALT levels, and viral load. Subjects with DHEAS levels >3.6 μmol/L at 15 years of age had more HBV viral titers decrement from 15 to 20 years of age (mean ± SD, 3.5 ± 2.5 vs. 1.2 ± 2.2 log10 copies/mL; P = 0.05) and shorter duration for HBeAg seroconversion than others (mean ± SD, 5.6 ± 4.4 vs. 9.2 ± 4.9 years; P = 0.02). Higher serum DHEAS levels at 15 years of age are also associated with greater hepatitis B surface antigen (HBsAg) titer decrement from 15 to 20 years of age (correlation coefficient = 0.45, P = 0.04).

Conclusions

Higher serum DHEAS levels at midpuberty predicts more HBV viral load and HBsAg titer decrement from midpuberty to young adulthood. Higher serum DHEAS levels at midpuberty also correlate with younger age of spontaneous HBeAg seroconversion in chronic genotype B and C HBV-infected patients.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22,707 men in Taiwan. Lancet. 1981;2:1129–33.PubMedCrossRef Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22,707 men in Taiwan. Lancet. 1981;2:1129–33.PubMedCrossRef
2.
Zurück zum Zitat Liu Z, Luo K, He H, Hou J. Hot-spot mutations in hepatitis B virus core gene: eliciting or evading immune clearance? J Viral Hepat. 2005;12:146–53.PubMedCrossRef Liu Z, Luo K, He H, Hou J. Hot-spot mutations in hepatitis B virus core gene: eliciting or evading immune clearance? J Viral Hepat. 2005;12:146–53.PubMedCrossRef
3.
Zurück zum Zitat Fattovich G, Rugge M, Brollo L, Pontisso P, Noventa F, Guido M, et al. Clinical, virologic, and histologic outcome following seroconversion from HBeAg to anti-HBe in chronic hepatitis type B. Hepatology. 1986;6:167–72.PubMedCrossRef Fattovich G, Rugge M, Brollo L, Pontisso P, Noventa F, Guido M, et al. Clinical, virologic, and histologic outcome following seroconversion from HBeAg to anti-HBe in chronic hepatitis type B. Hepatology. 1986;6:167–72.PubMedCrossRef
4.
Zurück zum Zitat Yang HI, Lu SN, Liaw YF, You SL, Sun CA, Wang LY, et al. Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med. 2002;347:168–74.PubMedCrossRef Yang HI, Lu SN, Liaw YF, You SL, Sun CA, Wang LY, et al. Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med. 2002;347:168–74.PubMedCrossRef
5.
Zurück zum Zitat Ni YH, Chang MH, Chen PJ, Tsai KS, Hsu HY, Chen HL, et al. Viremia profiles in children with chronic hepatitis B virus infection and spontaneous e antigen seroconversion. Gastroenterology. 2007;132:2340–5.PubMedCrossRef Ni YH, Chang MH, Chen PJ, Tsai KS, Hsu HY, Chen HL, et al. Viremia profiles in children with chronic hepatitis B virus infection and spontaneous e antigen seroconversion. Gastroenterology. 2007;132:2340–5.PubMedCrossRef
6.
Zurück zum Zitat Tseng TC, Liu CJ, Yang HC, Su TH, Wang CC, Chen CL, et al. High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load. Gastroenterology. 2012;142:1140–9.PubMedCrossRef Tseng TC, Liu CJ, Yang HC, Su TH, Wang CC, Chen CL, et al. High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load. Gastroenterology. 2012;142:1140–9.PubMedCrossRef
7.
Zurück zum Zitat Beasley RP, Trepo C, Stevens CE, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol. 1977;105:94–8.PubMed Beasley RP, Trepo C, Stevens CE, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol. 1977;105:94–8.PubMed
8.
Zurück zum Zitat Hsu SC, Chang MH, Ni YH, Hsu HY, Lee CY. Horizontal transmission of hepatitis B virus in children. J Pediatr Gastroenterol Nutr. 1993;16:66–9.PubMedCrossRef Hsu SC, Chang MH, Ni YH, Hsu HY, Lee CY. Horizontal transmission of hepatitis B virus in children. J Pediatr Gastroenterol Nutr. 1993;16:66–9.PubMedCrossRef
9.
Zurück zum Zitat Wu JF, Tsai WY, Hsu HY, Ni YH, Chen HL, Tsuei DJ, et al. The effect of puberty onset on spontaneous hepatitis B virus e antigen seroconversion in men. Gastroenterology. 2010;138:942–8.PubMedCrossRef Wu JF, Tsai WY, Hsu HY, Ni YH, Chen HL, Tsuei DJ, et al. The effect of puberty onset on spontaneous hepatitis B virus e antigen seroconversion in men. Gastroenterology. 2010;138:942–8.PubMedCrossRef
10.
Zurück zum Zitat Tseng TC, Liu CJ, Su TH, Wang CC, Chen CL, Chen PJ, et al. Serum hepatitis B surface antigen levels predict surface antigen loss in hepatitis B e antigen seroconverters. Gastroenterology. 2011;141:517–25.PubMedCrossRef Tseng TC, Liu CJ, Su TH, Wang CC, Chen CL, Chen PJ, et al. Serum hepatitis B surface antigen levels predict surface antigen loss in hepatitis B e antigen seroconverters. Gastroenterology. 2011;141:517–25.PubMedCrossRef
11.
Zurück zum Zitat Shiratori Y, Shiina S, Imamura M, Kato N, Kanai F, Okudaira T, et al. Characteristic difference of hepatocellular carcinoma between hepatitis B- and C-viral infection in Japan. Hepatology. 1995;22:1027–33.PubMedCrossRef Shiratori Y, Shiina S, Imamura M, Kato N, Kanai F, Okudaira T, et al. Characteristic difference of hepatocellular carcinoma between hepatitis B- and C-viral infection in Japan. Hepatology. 1995;22:1027–33.PubMedCrossRef
12.
Zurück zum Zitat Lee CM, Lu SN, Changchien CS, Yeh CT, Hsu TT, Tang JH, et al. Age, gender, and local geographic variations of viral etiology of hepatocellular carcinoma in a hyperendemic area for hepatitis B virus infection. Cancer. 1999;86:1143–50.PubMedCrossRef Lee CM, Lu SN, Changchien CS, Yeh CT, Hsu TT, Tang JH, et al. Age, gender, and local geographic variations of viral etiology of hepatocellular carcinoma in a hyperendemic area for hepatitis B virus infection. Cancer. 1999;86:1143–50.PubMedCrossRef
13.
Zurück zum Zitat Schuurs AH, Verheul HA. Effects of gender and sex steroids on the immune response. J Steroid Biochem Mol Biol. 1990;35:157–75.CrossRef Schuurs AH, Verheul HA. Effects of gender and sex steroids on the immune response. J Steroid Biochem Mol Biol. 1990;35:157–75.CrossRef
14.
Zurück zum Zitat Tung YC, Lee JS, Tsai WY, Hsiao PH. Physiological changes of adrenal androgens in childhood. J Formos Med Assoc. 2004;103:921–4.PubMed Tung YC, Lee JS, Tsai WY, Hsiao PH. Physiological changes of adrenal androgens in childhood. J Formos Med Assoc. 2004;103:921–4.PubMed
15.
Zurück zum Zitat Nawata H, Yanase T, Goto K, Okabe T, Nomura M, Ashida K, et al. Andropause. Horm Res. 2004;62:110–4.PubMedCrossRef Nawata H, Yanase T, Goto K, Okabe T, Nomura M, Ashida K, et al. Andropause. Horm Res. 2004;62:110–4.PubMedCrossRef
16.
Zurück zum Zitat Hazeldine J, Arlt W, Lord JM. Dehydroepiandrosterone as a regulator of immune cell function. J Steroid Biochem Mol Biol. 2010;120:127–36.PubMedCrossRef Hazeldine J, Arlt W, Lord JM. Dehydroepiandrosterone as a regulator of immune cell function. J Steroid Biochem Mol Biol. 2010;120:127–36.PubMedCrossRef
17.
Zurück zum Zitat Chittiprol S, Kumar AM, Shetty KT, Kumar HR, Satishchandra P, Rao RS, et al. HIV-1 clade C infection and progressive disruption in the relationship between cortisol, DHEAS and CD4 cell numbers: a two-year follow-up study. Clin Chim Acta. 2009;409:4–10.PubMedCentralPubMedCrossRef Chittiprol S, Kumar AM, Shetty KT, Kumar HR, Satishchandra P, Rao RS, et al. HIV-1 clade C infection and progressive disruption in the relationship between cortisol, DHEAS and CD4 cell numbers: a two-year follow-up study. Clin Chim Acta. 2009;409:4–10.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat de la Torre B, von Krogh G, Svensson M, Holmberg V. Blood cortisol and dehydroepiandrosterone sulfate (DHEAS) levels and CD4 T cell counts in HIV infection. Clin Exp Rheumatol. 1997;15:87–90.PubMed de la Torre B, von Krogh G, Svensson M, Holmberg V. Blood cortisol and dehydroepiandrosterone sulfate (DHEAS) levels and CD4 T cell counts in HIV infection. Clin Exp Rheumatol. 1997;15:87–90.PubMed
19.
Zurück zum Zitat Kutlu NO, Akinci A, Sönmezgöz E, Temel I, Evliyaoğlu E. The effects of androstenediol and dehydroepiandrosterone on the immune response to BCG at puberty. J Trop Pediatr. 2003;49:181–5.PubMedCrossRef Kutlu NO, Akinci A, Sönmezgöz E, Temel I, Evliyaoğlu E. The effects of androstenediol and dehydroepiandrosterone on the immune response to BCG at puberty. J Trop Pediatr. 2003;49:181–5.PubMedCrossRef
20.
Zurück zum Zitat dos Santos CD, Toldo MP, do Prado Júnior JC. Trypanosoma cruzi: the effects of dehydroepiandrosterone (DHEA) treatment during experimental infection. Acta Trop. 2005;95:109–15.PubMedCrossRef dos Santos CD, Toldo MP, do Prado Júnior JC. Trypanosoma cruzi: the effects of dehydroepiandrosterone (DHEA) treatment during experimental infection. Acta Trop. 2005;95:109–15.PubMedCrossRef
21.
Zurück zum Zitat Ben-Nathan D, Padgett DA, Loria RM. Androstenodiol and dehydroepiandrosterone protect mice against lethal bacterial infections and lipopolysaccharide toxicity. J Med Microbiol. 1999;48:421–31.CrossRef Ben-Nathan D, Padgett DA, Loria RM. Androstenodiol and dehydroepiandrosterone protect mice against lethal bacterial infections and lipopolysaccharide toxicity. J Med Microbiol. 1999;48:421–31.CrossRef
22.
Zurück zum Zitat Rasmussen KR, Martin EG, Healy MC. Effects of dehydroepiandrosterone in immune suppressed rats infected with Cryptosporidium parvum. J Parasitol. 1993;79:364–70.PubMedCrossRef Rasmussen KR, Martin EG, Healy MC. Effects of dehydroepiandrosterone in immune suppressed rats infected with Cryptosporidium parvum. J Parasitol. 1993;79:364–70.PubMedCrossRef
23.
Zurück zum Zitat Leenstra T, ter Kuile FO, Kariuki SK, Nixon CP, Oloo AJ, Kager PA, et al. Dehydroepiandrosterone sulphate levels associated with decreased malaria parasite density and increased hemoglobin concentration in pubertal girls from western Kenya. J Infect Dis. 2003;188:297–304.PubMedCrossRef Leenstra T, ter Kuile FO, Kariuki SK, Nixon CP, Oloo AJ, Kager PA, et al. Dehydroepiandrosterone sulphate levels associated with decreased malaria parasite density and increased hemoglobin concentration in pubertal girls from western Kenya. J Infect Dis. 2003;188:297–304.PubMedCrossRef
24.
Zurück zum Zitat Morales-Montor J, Newhouse E, Mohamed F, Baghdadi A, Damian RT. Altered levels of hypothalamic-pituitary-adrenocortical axis hormones in baboons and mice during the course of infection with Schistosoma mansoni. J Infect Dis. 2001;183:313–20.PubMedCrossRef Morales-Montor J, Newhouse E, Mohamed F, Baghdadi A, Damian RT. Altered levels of hypothalamic-pituitary-adrenocortical axis hormones in baboons and mice during the course of infection with Schistosoma mansoni. J Infect Dis. 2001;183:313–20.PubMedCrossRef
25.
Zurück zum Zitat Christeff N, Melchior JC, Mammes O, Gherbi N, Dalle MT, Nunez EA. Correlation between increase cortisol: DHEA ratio and malnutrition in HIV-positive men. Nutrition. 1999;15:534–9.PubMedCrossRef Christeff N, Melchior JC, Mammes O, Gherbi N, Dalle MT, Nunez EA. Correlation between increase cortisol: DHEA ratio and malnutrition in HIV-positive men. Nutrition. 1999;15:534–9.PubMedCrossRef
26.
Zurück zum Zitat Butcher SK, Killampalli V, Lascelles D, Wang K, Alpar EK, Lord JM. Raised cortisol: DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity. Aging Cell. 2005;4:319–24.PubMedCrossRef Butcher SK, Killampalli V, Lascelles D, Wang K, Alpar EK, Lord JM. Raised cortisol: DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity. Aging Cell. 2005;4:319–24.PubMedCrossRef
27.
Zurück zum Zitat Barkhausen T, Westphal BM, Pütz C, Krettek C, van Griensven M. Dehydroepiandrosterone administration modulates endothelial and neutrophil adhesion molecule expression in vitro. Crit Care. 2006;10:R109.PubMedCentralPubMedCrossRef Barkhausen T, Westphal BM, Pütz C, Krettek C, van Griensven M. Dehydroepiandrosterone administration modulates endothelial and neutrophil adhesion molecule expression in vitro. Crit Care. 2006;10:R109.PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Radford DJ, Wang K, McNelis JC, Taylor AE, Hechenberger G, Hofmann J, et al. Dehydroepiandrosterone sulfate directly activates protein kinase C-beta to increase human neutrophil superoxide generation. Mol Endocrinol. 2010;24:813–21.PubMedCrossRef Radford DJ, Wang K, McNelis JC, Taylor AE, Hechenberger G, Hofmann J, et al. Dehydroepiandrosterone sulfate directly activates protein kinase C-beta to increase human neutrophil superoxide generation. Mol Endocrinol. 2010;24:813–21.PubMedCrossRef
29.
Zurück zum Zitat Yang BC, Liu CW, Chen YC, Yu CK. Exogenous dehydroepiandrosterone modified the expression of T helper related cytokines in NZB/NZWF1 mice. Immun Investig. 1998;27:291–302.CrossRef Yang BC, Liu CW, Chen YC, Yu CK. Exogenous dehydroepiandrosterone modified the expression of T helper related cytokines in NZB/NZWF1 mice. Immun Investig. 1998;27:291–302.CrossRef
30.
Zurück zum Zitat Araneo BA, Woods ML 2nd, Daynes RA. Reversal of the immunosenescent phenotype by dehydroepiandrosterone: hormone treatment provides an adjuvant effect on the immunization of aged mice with recombinant hepatitis B surface antigen. J Infect Dis. 1993;167:830–40.PubMedCrossRef Araneo BA, Woods ML 2nd, Daynes RA. Reversal of the immunosenescent phenotype by dehydroepiandrosterone: hormone treatment provides an adjuvant effect on the immunization of aged mice with recombinant hepatitis B surface antigen. J Infect Dis. 1993;167:830–40.PubMedCrossRef
31.
Zurück zum Zitat Chen YC, Huang SF, Chu CM, Liaw YF. Serial HBV DNA levels in patients with persistently normal transaminase over 10 years following spontaneous HBeAg seroconversion. J Viral Hepat. 2012;19:138–46.PubMedCrossRef Chen YC, Huang SF, Chu CM, Liaw YF. Serial HBV DNA levels in patients with persistently normal transaminase over 10 years following spontaneous HBeAg seroconversion. J Viral Hepat. 2012;19:138–46.PubMedCrossRef
32.
Zurück zum Zitat Liaw YF, Lau GK, Kao JH, Gane E. Hepatitis B e antigen seroconversion: a critical event in chronic hepatitis B virus infection. Dig Dis Sci. 2010;55:2727–34.PubMedCrossRef Liaw YF, Lau GK, Kao JH, Gane E. Hepatitis B e antigen seroconversion: a critical event in chronic hepatitis B virus infection. Dig Dis Sci. 2010;55:2727–34.PubMedCrossRef
33.
Zurück zum Zitat Wu JF, Su YR, Chen CH, Chen HL, Ni YH, Hsu HY, Wang JL, Chang MH. Predictive effect of serial serum alanine aminotransferase levels on spontaneous HBeAg seroconversion in chronic genotypes B and C HBV-infected children. J Pediatr Gastroenterol Nutr. 2012;54:97–100.PubMedCentralPubMedCrossRef Wu JF, Su YR, Chen CH, Chen HL, Ni YH, Hsu HY, Wang JL, Chang MH. Predictive effect of serial serum alanine aminotransferase levels on spontaneous HBeAg seroconversion in chronic genotypes B and C HBV-infected children. J Pediatr Gastroenterol Nutr. 2012;54:97–100.PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Kao JH, Chen PJ, Lai MY, Chen DS. Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers. J Med Virol. 2004;72:363–9.PubMedCrossRef Kao JH, Chen PJ, Lai MY, Chen DS. Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers. J Med Virol. 2004;72:363–9.PubMedCrossRef
35.
Zurück zum Zitat Tseng YR, Wu JF, Ni YH, Chen HL, Chen CC, Wen WH, Hsu HY, Chang MH. Long term effect of maternal HBeAg on delayed HBeAg seroconversion in offspring with chronic hepatitis B infection. Liver Int. 2011;31:1373–80.PubMedCrossRef Tseng YR, Wu JF, Ni YH, Chen HL, Chen CC, Wen WH, Hsu HY, Chang MH. Long term effect of maternal HBeAg on delayed HBeAg seroconversion in offspring with chronic hepatitis B infection. Liver Int. 2011;31:1373–80.PubMedCrossRef
36.
Zurück zum Zitat Chu CM, Liaw YF. Predictive factors for reactivation of hepatitis B following hepatitis B e antigen seroconversion in chronic hepatitis B. Gastroenterology. 2007;133:1458–65.PubMedCrossRef Chu CM, Liaw YF. Predictive factors for reactivation of hepatitis B following hepatitis B e antigen seroconversion in chronic hepatitis B. Gastroenterology. 2007;133:1458–65.PubMedCrossRef
Metadaten
Titel
Role of serum dehydroepiandrosterone sulfate level on the clearance of chronic hepatitis B virus infection
verfasst von
Jia-Feng Wu
Wen-Yu Tsai
Yi-Ching Tung
Huey-Ling Chen
Yen-Hsuan Ni
Hong-Yuan Hsu
Mei-Hwei Chang
Publikationsdatum
01.05.2014
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 5/2014
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-013-0831-0

Weitere Artikel der Ausgabe 5/2014

Journal of Gastroenterology 5/2014 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.