Wu Jia-Feng, Tsai Wen-Yu, Tung Yi-Ching, Chen Huey-Ling, Ni Yen-Hsuan, Hsu Hong-Yuan, Chang Mei-Hwei
Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan.
J Gastroenterol. 2014 May;49(5):900-6. doi: 10.1007/s00535-013-0831-0. Epub 2013 Jun 1.
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.
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.
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).
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.
慢性乙型肝炎病毒（HBV）感染的自然病程及相关宿主因素仍不明确。本研究旨在探讨硫酸脱氢表雄酮（DHEAS）对慢性HBV感染清除的影响。
招募了201例乙型肝炎e抗原（HBeAg）阳性的慢性HBV感染儿童（101例女性）。在所有受试者15岁时测定血清DHEAS水平。纳入血清丙氨酸氨基转移酶（ALT）水平、DHEAS水平、HBV血清学标志物、基因型和病毒载量进行分析。
青春期中期血清DHEAS水平>3.6 μmol/L的受试者HBeAg血清学转换更早（中位年龄，14.7岁对18.2岁；风险比，1.9；P = 0.03），即使在调整性别、HBV基因型、ALT峰值水平和病毒载量后，这种影响仍然存在。15岁时DHEAS水平>3.6 μmol/L的受试者在15至20岁时HBV病毒滴度下降更多（均值±标准差，3.5±2.5对1.2±2.2 log10拷贝/mL；P = 0.05），且HBeAg血清学转换持续时间比其他受试者短（均值±标准差，5.6±4.4对9.2±4.9年；P = 0.02）。15岁时较高的血清DHEAS水平还与15至20岁时更高的乙型肝炎表面抗原（HBsAg）滴度下降相关（相关系数 = 0.45，P = 0.04）。
青春期中期较高的血清DHEAS水平预示着从青春期中期到青年期HBV病毒载量和HBsAg滴度下降更多。青春期中期较高的血清DHEAS水平还与慢性B型和C型HBV感染患者自发HBeAg血清学转换的年龄较小相关。
