Low plasma levels of dehydroepiandrosterone sulphate in HIV-positive patients coinfected with hepatitis C virus

Objectives To evaluate plasma levels of dehydroepiandrosterone sulphate (DHEAS) in a cohort of HIV-infected patients and to analyse factors associated with DHEAS levels. Methods We conducted a cross-sectional survey in the Nimes University Hospital cohort of HIV-infected patients in south-eastern France. All HIV-infected patients with at least one outpatient visit between I January and I September 2002 were included in the study. Sociodemographic, clinical, therapeutic, immuno-virological and plasma DHEAS level data were collected during this period. Hepatitis C virus (HCV) coinfection was defined as the presence of HCV antibody with positive RNA. To identify factors associated with plasma DHEAS levels, Spearman's rank correlation and univariate and multivariate linear regression analyses were used. Results The DHEAS plasma level was measured in 137 patients (104 men and 33 women), 37 (27.0%) of whom were HCV coinfected. The median age of the patients was 39.1 years [interquartile range (IQR): 34.9-48.7] for women and 41.8 years (36.5-47.7) for men. The median DHEAS level was 5.5 mumol/L (IQR: 2.3-8.8) for the whole sample of 137 patients, and was lower in women (2.4 mumol/L; 1.5-6.6) than in men (6.1 mumol/L; 2.5-9.0) (P<0.01), and lower in patients coinfected with HCV (2.1 mumol/L: 0.6-6.7) than in those not coinfected (6.6 mumol/L; 3.0-9.1) (P< 0.01). Of all prognostic factors studied in the variance covariance analysis, three factors were associated with DHEAS: age, gender and HCV coinfection. Subgroup analysis revealed that the age-adjusted mean of the DHEAS level was lower in HCV coinfected patients for both women (1.3 +/- 1.1 mumol/L) and men (4.0 +/- 0.7 mumol/L), compared with patients not HCV coinfected (women, 5.3 +/- 0.7 mumol/L; men, 7.2 +/- 0.4 mumol/L) (P<0.01). Conclusions This is the first report of the determination of DHEAS plasma levels in HIV/HCV` coinfected patients. When age and sex were taken into account, the DHEAS plasma level was found to be significantly lower in HCV coinfected patients. To date, the pathophysiology of such findings is unknown.