Vicari E, Arcoria D, Di Mauro C, Noto R, Noto Z, La Vignera S
Department of Biomedical Sciences, Garibaldi Hospital, University of Catania, Catania, Italy.
Minerva Med. 2006 Feb;97(1):65-77.
The aim of this study was to evaluate the sperm abnormalities in young infertile patients with hepatitis B (HBV) or C (HCV) virus infection and to evaluate the additional negative influence of varicocele on sperm parameters in these patients.
Part I. Forty-two infertile patients in Child-Pugh classification A with HBV (n=23) or HCV (n=19) infection, underwent sperm analysis and quantitative detection of HBV-DNA or HCV-RNA in blood serum. Sperm parameters were compared to those of a group of 30 patients with primary infertility due to causes different from liver diseases and/or varicocele). Part II. Twenty-one infertile patients with varicocele associated to HBV (n=11) or HCV (n=10) infection were also enrolled and underwent semen analysis: a group of 39 patients without liver disease, but with varicocele alone served as matched-control group.
Part I. HBV patients (with a median HBV-DNA load of 6x10(5) copies/mL, range 1x10(5)-10x10(6)) showed median sperm parameters (sperm density, total number, forward motility and morphology, viability) significantly worse than those found in patients with HCV (with a median HCV-RNA load of 2.3x10(6) copies/mL, range (2x10(5)-12x10(6)). Sperm parameters showed no significant correlation with the duration of infertility neither with the duration of viral infection. Sperm morphology only, exhibited a trend (P=0.06) of negative correlationship (r=-0.59) with the viral HBV-DNA load, whereas the other sperm parameters studied showed no correlation with the viral load. Part II. The group of infertile patients with HBV and varicocele showed median values of all sperm parameter evaluated significantly worse than those found in infertile patients with varicocele alone, or with HCV infection plus varicocele.
Patients with HBV infection show worse sperm parameters compared with HCV patients. The additional presence of varicocele further impairs sperm output in HBV patients.
本研究旨在评估感染乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）的年轻不育患者的精子异常情况，并评估精索静脉曲张对这些患者精子参数的额外负面影响。
第一部分。42例Child-Pugh A级的HBV感染（n = 23）或HCV感染（n = 19）的不育患者，接受了精子分析以及血清中HBV-DNA或HCV-RNA的定量检测。将精子参数与一组30例因肝病和/或精索静脉曲张以外原因导致原发性不育的患者进行比较。第二部分。还纳入了21例与HBV（n = 11）或HCV（n = 10）感染相关的精索静脉曲张不育患者，并进行了精液分析：一组39例无肝病但仅有精索静脉曲张的患者作为匹配对照组。
第一部分。HBV患者（HBV-DNA载量中位数为6×10⁵拷贝/mL，范围为1×10⁵ - 10×10⁶）的精子参数中位数（精子密度、总数、前向运动能力、形态、活力）明显低于HCV患者（HCV-RNA载量中位数为2.3×10⁶拷贝/mL，范围为2×10⁵ - 12×10⁶）。精子参数与不育持续时间以及病毒感染持续时间均无显著相关性。仅精子形态与病毒HBV-DNA载量呈负相关趋势（P = 0.06，r = -0.59），而其他研究的精子参数与病毒载量无相关性。第二部分。HBV合并精索静脉曲张的不育患者组，所有评估的精子参数中位数均明显低于单纯精索静脉曲张不育患者或HCV感染合并精索静脉曲张患者。
与HCV患者相比，HBV感染患者的精子参数更差。精索静脉曲张的额外存在进一步损害了HBV患者的精子生成。
