Department of Hepatology, National Liver Institute, Menoufia University, Al Minufya, Egypt.
Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Al Minufya, Egypt.
J Sex Med. 2019 Mar;16(3):402-409. doi: 10.1016/j.jsxm.2019.01.309.
Chronic hepatitis C virus (HCV) infection is a global health burden that affects quality of life, with a negative impact on sexual functioning (SF).
To study male sexual dysfunction (MSD) among Egyptian men with chronic HCV infection and the impact of therapy with direct-acting antiviral drugs (DAAs) on their sexual health.
The self-administered International Index of Erectile Function (IIEF) questionnaire was completed by 400 sexually active male patients with chronic HCV infection without liver cirrhosis before the initiation of therapy with DAAs and then again at the completion of therapy. We compared these baseline questionnaires with those completed by a similar number of age-matched and socioeconomic status-matched controls. In the patients with HCV infection, we also compared IIEF questionnaires completed before and after DAA therapy.
We determined the proportions of patients and controls who were dissatisfied with their sexual life and the impact of clearing HCV infection on MSD and evaluated the impact of DAA therapy on the total IIEF score and scores in all IIEF domains.
Men with chronic HCV infection before DAA treatment had significantly higher erectile dysfunction (ED) scores compared with controls, and scores increased with age (P < .0001). The average scores in all IIEF domains was significantly lower in the patients compared with controls in all age groups. Men with chronic HCV infection had significantly higher ED scores before cure than after cure (P < .0001).
Given the high prevalence of MSD in patients with chronic HCV infection, and given that curing the HCV virus can improve the MSD associated with HCV infection, it is recommended that sexual quality of life in men with HCV be addressed as part of the evaluation protocol before initiation of DAA treatment and again after cure in an effort to improve this particular aspect of quality of life.
STRENGTHS & LIMITATIONS: This is the first study to report on MSD in the era of DAA therapy in Egyptian men with chronic HCV infection before the development of cirrhosis, with a relatively large study population. The use of a detailed version of the IIEF questionnaire reinforces the validity of our study.
Chronic HCV infection negatively impacts MSD, affecting all domains of the IIEF, and effects increase with age. The MSD associated with HCV infection is significantly improved in patients who are cleared of the virus. These findings require further confirmation and need to be addressed as part of a comprehensive therapeutic plan to improve patients' quality of life. Elshimi E, Morad W, Mohamad NE. Male Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C Virus Infection Before and After Direct-Acting Antiviral Drugs. J Sex Rev 2019;16:402-409.
慢性丙型肝炎病毒（HCV）感染是一种全球性的健康负担，影响生活质量，对性功能产生负面影响。
研究埃及慢性 HCV 感染男性的男性性功能障碍（MSD）以及直接作用抗病毒药物（DAA）治疗对其性健康的影响。
400 名患有慢性 HCV 感染且无肝硬化的活跃男性患者在开始 DAA 治疗前和完成治疗后自行填写国际勃起功能指数（IIEF）问卷。我们将这些基线问卷与具有相似年龄和社会经济地位的对照组的问卷进行了比较。在 HCV 感染患者中，我们还比较了 DAA 治疗前后的 IIEF 问卷。
我们确定了对性生活不满意的患者和对照组的比例，以及清除 HCV 感染对 MSD 的影响，并评估了 DAA 治疗对总 IIEF 评分和所有 IIEF 领域评分的影响。
在开始 DAA 治疗之前，患有慢性 HCV 感染的男性的勃起功能障碍（ED）评分明显高于对照组，且评分随年龄增长而增加（P<0.0001）。在所有年龄组中，与对照组相比，患者的所有 IIEF 领域的平均评分均明显较低。在 HCV 感染治愈后，男性的 ED 评分明显低于治愈前（P<0.0001）。
鉴于慢性 HCV 感染患者中 MSD 的高患病率，以及治愈 HCV 病毒可以改善与 HCV 感染相关的 MSD，建议在开始 DAA 治疗前和治愈后评估 HCV 男性的性健康，以改善生活质量的这一方面。
这是第一项在埃及男性中报道慢性 HCV 感染患者在肝硬化发生之前 DAA 治疗时代的 MSD 的研究，研究人群相对较大。使用详细版本的 IIEF 问卷增强了我们研究的有效性。
慢性 HCV 感染对 MSD 有负面影响，影响 IIEF 的所有领域，并且随着年龄的增长而增加。清除病毒的患者的 HCV 相关 MSD 明显改善。这些发现需要进一步证实，并作为综合治疗计划的一部分加以解决，以改善患者的生活质量。
