Sex Hormones, Prolactin, and Platelet Indices as Predictors of Sustained Virological Response in Male Patients with Chronic Hepatitis C Genotype 4 Receiving Combined Antiviral Therapy (Pegylated Interferon and Ribavirin)

Background: Hepatitis C virus (HCV) is one of the most noxious infectious diseases; however the impact of gender on the response to HCV still poorly understood. Aim: We aimed to investigate platelet indices, testosterone and prolactin levels as predictors of sustained virological response (SVR) in chronic hepatitis C (CHC). Methods: Liver biopsy, serum testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and platelet parameters were evaluated to 86 men with CHC who were divided into 51 patients with early fibrosis and 35 patients with late fibrosis. Patients receiving pegylated interferon and ribavirin for 48 weeks; then follow up for 6 months. Results: Patients with early fibrosis showed lower total testosterone and higher free testosterone levels (P<0.001) than those with higher fibrosis scores. A univariate analysis showed that age, viral load, liver fibrosis, platelet count and indices, total and free testosterone and prolactin levels were associated with SVR. In a multivariate analysis, liver fibrosis (F0–2), platelet count ?140 x103/mm3, mean platelet volume (MPV) ? 8.5 fL, total testosterone ? 17.5 nmol/L, free testosterone ? 0. 07 nmol/L and prolactin ? 185 mIU/L were independently associated with SVR. Conclusion: Higher levels of platelet count and free testosterone levels as well as lower levels of total testosterone, MPV and prolactin levels may be good predictors of SVR. We recommend screening for thrombocytopenia; total testosterone deficiency and prolactin elevation in CHC infection should selectively target men with more severe liver disease or documented higher fibrosis stages.