In the present study, we confirmed that men with HBV-ACLF had lower levels of TT, FTI, DHEAS and cortisol and higher levels of androstenedione compared with age- and BMI-matched healthy controls and those with chronic hepatitis B. In secondary analysis among HBV-ACLF cases, lower levels of TT, FTI, and SHBG and higher levels of androstenedione are strongly associated with higher stages of HBV-ACLF and increased clinical severity of HBV-ACLF according to complications (ascites and hepatic encephalopathy) and multiple severity scores (MELD and COSSH-ACLF scores). Here, SHBG is linked to chronic hepatitis B virus infection.