Hsiao Po-Jen, Hsieh Po-Fan, Chou Eric Chieh-Lung, Lai Hsueh-Chou, Peng Cheng-Yuan, Su Kuan-Pin
Department of Urology, China Medical University Hospital, Taichung, Taiwan.
School of Chinese Medicine, China Medical University, Taichung, Taiwan.
PLoS One. 2016 Aug 9;11(8):e0160450. doi: 10.1371/journal.pone.0160450. eCollection 2016.
Peg-interferon (PegIFN)α2a or PegIFNα2b plus ribavirin (RBV) is the standard therapy for chronic hepatitis C virus (HCV) infection in Taiwan and Asia. It is commonly associated with adverse effects, but the issue of sexual and mental health is not well reported. This study aimed to evaluate the impact of anti-viral therapy with PegIFNα plus RBV on sexual desire and depression.
This prospective cohort study from 2009 to 2014 enrolled 181 patients with HCV who received PegIFNα2a (180 mcg/week) or PegIFNα2b (1.5 mcg/Kg/week) plus RBV (800-1200 mg/day) according to response-guide therapy for 24 to 48 weeks in a tertiary medical center. Patients with decreased sexual desire (DSD) before PegIFNα plus RBV were excluded. Patients were evaluated at baseline (week 0) and after 2, 4, 8, 12, 16, 20, and 24 weeks of PegIFNα plus RBV treatment using the structured Mini-International Neuropsychiatric Interview, for the diagnosis of a major depressive episode, and the 21-item Beck Depression Inventory (BDI), for monitoring depressive symptoms. The 21st item of the BDI was used to evaluate DSD.
During therapy, 124 (68.5%) patients had DSD. The BDI score peaked at 14.8 weeks. The severity of DSD was greatest at 16 weeks of treatment. The average score of the 21st item of the BDI correlated with DSD. Depression history and the prevalence of subsequent major depressive disorder after anti-viral therapy was correlated to DSD (p = 0.05 and 0.001). Male patients complained of DSD more significantly than females (p = 0.031).
Decreased sexual desire is common but is usually neglected in patients with chronic hepatitis C undergoing anti-viral therapy, especially among male patients. Physicians must be monitoring the side effects of sexual health and depression.
聚乙二醇干扰素（PegIFN）α2a或PegIFNα2b联合利巴韦林（RBV）是台湾和亚洲慢性丙型肝炎病毒（HCV）感染的标准治疗方案。该治疗方案常伴有不良反应，但关于性健康和心理健康问题的报道并不充分。本研究旨在评估PegIFNα联合RBV抗病毒治疗对性欲和抑郁的影响。
这项前瞻性队列研究于2009年至2014年在一家三级医疗中心开展，纳入了181例HCV患者，这些患者根据应答指导疗法接受PegIFNα2a（180 mcg/周）或PegIFNα2b（1.5 mcg/Kg/周）联合RBV（800 - 1200 mg/天）治疗24至48周。排除在接受PegIFNα联合RBV治疗前已有性欲减退（DSD）的患者。在基线（第0周）以及PegIFNα联合RBV治疗的第2、4、8、12、16、20和24周，使用结构化的迷你国际神经精神访谈来诊断重度抑郁发作，并使用21项贝克抑郁量表（BDI）来监测抑郁症状。BDI的第21项用于评估DSD。
治疗期间，124例（68.5%）患者出现DSD。BDI评分在14.8周时达到峰值。DSD的严重程度在治疗第16周时最为明显。BDI第21项的平均得分与DSD相关。抑郁病史以及抗病毒治疗后随后发生重度抑郁障碍的患病率与DSD相关（p = 0.05和0.001）。男性患者抱怨DSD的情况比女性更显著（p = 0.031）。
性欲减退在接受抗病毒治疗的慢性丙型肝炎患者中较为常见，但通常被忽视，尤其是男性患者。医生必须监测性健康和抑郁方面的副作用。
