Multivariate Assessment of Thyroid, Lipid, and Inflammatory Profiles by HBV Status and Viral Load: Age- and Sex-Specific Findings.

Abstract

Chronic hepatitis B virus (HBV) infection may influence extrahepatic systems, including endocrine and lipid regulation. In this cross-sectional study, 186 adults were stratified by HBV DNA status and viral load to examine thyroid function, systemic inflammation, and lipid metabolism, with further analyses by age and sex. Thyroid-stimulating hormone (TSH, a pituitary regulator of thyroid function) levels were significantly lower in HBsAg-positive individuals compared with controls; however, this association was attenuated after stratification by viral load, indicating that the relationship is not unequivocally independent of HBV DNA levels, as free thyroxine (FT4, the circulating thyroid hormone reflecting gland activity) levels remained stable. Lipid profiles displayed demographic-specific patterns: males with high viral load exhibited lower HDL cholesterol, whereas younger HBV-positive individuals showed higher LDL cholesterol. CRP levels were unaffected by HBV status or viral load, aligning with the absence of systemic inflammation in early or inactive disease stages. Age was a major determinant across biomarkers, with complex interactions involving sex and viral load. These findings indicate subtle but clinically relevant extrahepatic effects of HBV infection and underscore the need for personalized monitoring and longitudinal studies to clarify metabolic and cardiovascular implications. These subgroup trends should be interpreted with caution given the absence of BMI, liver enzyme, fibrosis, medication, and comorbidity data in this retrospective cohort.