title: Elevation of serum sex hormone-binding globulin in females with fulminant hepatitis B virus infection.
abstract: Amongst adults exposed to the hepatitis B virus (HBV), the infection pursues a fulminant course more frequently in females, while conversely a chronic carrier state is more frequent in males. Because of these differences in sex ratio, we investigated the relationship between the outcome of HBV infection and serum concentrations of sex hormone-binding globulin (SHBG), a circulating glycoprotein that exerts an important influence on the balance of free sex hormones. SHBG levels were significantly elevated in females with fulminant HBV infection compared to females with either uncomplicated acute or chronic HBV infection (P less than .05 and P less than .001, respectively). That this was not a nonspecific effect of fulminant hepatitis was confirmed by the significantly higher levels in this group than in age-matched females with fulminant hepatitis unrelated to HBV (P less than .05). In contrast, four of 15 female HBsAg carriers had SHBG values in the male range, and these included three of four patients who had acquired HBV as adults. SHBG levels were normal in all male groups. These results suggested that for adults the hormonal environment may be important in determining the course of HBV infection.
authors.affiliation: Liver Unit, King's College School of Medicine and Dentistry, London, England.
authors.forename: A
authors.initials: A
authors.lastname: Forbes
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: H M
authors.initials: HM
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000208:Acute Disease; D002353:Carrier State; D005260:Female; D006509:Hepatitis B / Q000097:blood* / Q000503:physiopathology; D008297:Male; D012737:Sex Factors; D012738:Sex Hormone-Binding Globulin / Q000032:analysis*
chemical_list: D012738:Sex Hormone-Binding Globulin