Female Sex Hormones Pattern and Its Relation to Disease Severity and Treatment in Pre- and Postmenopausal Patients with Chronic Hepatitis C Virus (Genotype 4) Infection.

Nora H Ahmed,Hesham F El-Sayed,Taher I El-Serafi,Taghrid B El-Abaseri

doi:10.1155/2015/927974

Nora H Ahmed, Hesham F El-Sayed + Show 2 more

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https://doi.org/10.1155/2015/927974

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Abstract

Chronic hepatitis C (CHC) course revealed differences between men and women. Male gender and postmenopausal women are thought to be of the critical factors affecting HCV infection progression. The study aimed to assess female sex hormones and their relation to disease severity and treatment in HCV infected females. Subjects were divided to 2 groups: 44 CHC female patients and 44 controls. Both groups were classified to premenopausal and postmenopausal females. Serum estradiol (E2), progesterone (PRG), and total testosterone (TT) were assessed using chemiluminescent immunoassay. Our results showed that menopausal patients had significantly higher levels of estradiol, total testosterone, and progesterone compared to controls (P < 0.001). Reproductive aged patients had lower level of total testosterone compared to menopausal patients (P < 0.001). HCV infected females of reproductive age had higher level of progesterone compared to menopausal HCV infected females (P = 0.0014). Indicators of disease severity and treatment response were significantly worse in menopausal women compared to reproductive aged women (fibrosis: P < 0.001, activity: P = 0.045, and treatment: P < 0.001). We observed that lower estradiol level may be related to fibrosis severity in CHC females. Higher total testosterone and progesterone levels may be related to fibrosis severity and poor response to treatment in CHC menopausal females only.

Highlights

Hepatitis C is caused by HCV infection
Among the baseline laboratory data platelets count and albumin levels were significantly lower (P = 0.007 and 0.03, resp.), while International Normalized Ratio (INR) level was significantly higher (P = 0.005) in the menopausal patients compared to the reproductive aged patients
Hormonal levels in the studied subjects showed that estradiol level is higher in menopausal patients compared to their healthy controls (P < 0.001) (Table 1)

Summary

Introduction

Hepatitis C is caused by HCV infection. It is estimated that about 3% of the world’s population has been infected with HCV and 170 million are chronic carriers at risk of developing liver cirrhosis and/or liver cancer [1]. Prevalence of HCV in Egypt is 14.7% [2]. The clinical course of chronic hepatitis C revealed several differences between men and women. Male gender is thought to be one of the critical factors in the progression of HCV infection [3]. The development of hepatic fibrosis is faster in postmenopausal than in premenopausal women [4]. Serum total testosterone is associated with increased risk of both advanced hepatic fibrosis and advanced hepatic inflammatory activity in HCV infected men [5]

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