Urology Department, Faculty of Medicine, Benha University, Benha, Egypt.
Internal Medicine Department, Faculty of Medicine, Benha University, Benha, Egypt.
Endocr Metab Immune Disord Drug Targets. 2022;22(3):310-317. doi: 10.2174/1871530321666210212143932.
BACKGROUND & OBJECTIVE: Erectile dysfunction (ED) is one of the extrahepatic manifestations of hepatitis C virus infection that greatly affects patients' quality of life. Unfortunately, some of the drugs used for HCV treatment may have a negative impact on the patient's erectile function, such as the pegylated interferon. Currently, with the introduction of direct-acting antiviral drugs, there is scarce data in the literature about its potential impact on erectile function. In these settings, we aimed to assess the impact of sofosbuvir-based therapy on male erectile function.
This prospective interventional study was carried out in Benha University hospitals between January 2019 and May 2020. The study included all consecutive HCV patients with simultaneous ED coming to the hepatology outpatient clinic. Patients were divided into a study group who received sofosbuvir-based therapy (group A) or a control group who received silymarin therapy (group B). The International Index of Erectile Function-5 (IIEF-5) was used for the assessment of erectile function at different time points (pretreatment, 6 months, and 12 months after treatment). Different variables in both groups have been statistically analyzed.
Overall, 75 patients who received sofosbuvir-based therapy and a control group (n = 35) matched for age and pretreatment variables (Child-Turcotte-Pugh score and Fibrosis-4 score). There was no significant difference between both groups in the pretreatment data. On the other hand, the posttreatment IIEF-5 was significantly higher in the sofosbuvir arm compared to the silymarin arm both at six months (p<0.001) and at 12 months (p<0.001). Furthermore, the age and the stage of liver fibrosis were negatively correlated with IIEF-5 at all-time points.
The age and the stage of liver fibrosis are significantly correlated with the degree of ED. Furthermore, sofosbuvir-based therapy may be associated with significant improvement in patients with erectile function.
勃起功能障碍（ED）是丙型肝炎病毒感染的肝外表现之一，极大地影响了患者的生活质量。不幸的是，一些用于治疗 HCV 的药物可能会对患者的勃起功能产生负面影响，例如聚乙二醇干扰素。目前，随着直接作用抗病毒药物的引入，关于其对勃起功能潜在影响的文献数据很少。在这些情况下，我们旨在评估基于索非布韦的治疗对男性勃起功能的影响。
这项前瞻性干预研究于 2019 年 1 月至 2020 年 5 月在本哈大学医院进行。研究包括同时患有 ED 并来肝病门诊就诊的所有连续 HCV 患者。患者被分为接受基于索非布韦的治疗的研究组（A 组）或接受水飞蓟素治疗的对照组（B 组）。国际勃起功能指数-5（IIEF-5）用于在不同时间点（治疗前、治疗后 6 个月和 12 个月）评估勃起功能。对两组的不同变量进行了统计学分析。
共有 75 名接受基于索非布韦的治疗的患者和一组年龄和治疗前变量（Child-Turcotte-Pugh 评分和纤维化-4 评分）匹配的对照组（n = 35）。两组在治疗前数据方面没有显著差异。另一方面，与水飞蓟素组相比，索非布韦组在治疗后 6 个月（p<0.001）和 12 个月（p<0.001）时 IIEF-5 明显更高。此外，年龄和肝纤维化分期与所有时间点的 IIEF-5 呈负相关。
年龄和肝纤维化分期与 ED 程度显著相关。此外，基于索非布韦的治疗可能与患者勃起功能的显著改善相关。
