Epidemiology

Sexual dysfunction common among men with HCV

Last Updated: 2006-07-11 16:25:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Among men with chronic hepatitis C infection (HCV), the prevalence of sexual dysfunction is highly prevalent, and it is not associated with age or underlying depression, new prospective study results suggest.

Small studies in Italy and Turkey have demonstrated reduced sexual functioning among men with HCV, senior investigator Dr. Edmund J. Bini and associates note. However, little is known about sexual symptoms, depression or health-related quality of life in HCV-infected men in the US.

Dr. Bini's group recruited 112 men with HVC and 239 control subjects treated at the Veterans Affairs New York Harbor Healthcare System in New York City from January 2004 through March 2005. Excluded were patients with decompensated cirrhosis or those who were treated with interferon or ribavirin in the previous 6 months.

As reported in the June issue of the American Journal of Gastroenterology, the subjects completed questionnaires to assess sexual function, depression, and health-related quality of life.

The researchers found 53.6% of the HCV-infected men reported they were not sexually satisfied compared with 28.9% of the controls (p < 0.001). After adjusting for demographic and clinical characteristics, the odds ratio for sexual dissatisfaction was 3.36 among HCV-positive patients.

The same statistically significant pattern was observed for the other four domain scores of the Brief Male Sexual Function Inventory (sex drive, erectile function, ejaculation, and sexual problem assessment), regardless of marital or socioeconomic status or age.

The HCV-positive men were also more likely to have used sildenafil within the previous 30 days (19.6% versus 9.6%).

The men with hepatitis also reported worse health-related quality of life on all eight domains of the Medical Outcomes Study Short Form 36 (SF-36). Multivariable logistic regression analysis showed that elevated alanine aminotransferase levels and HCV viral load > 2 million copies/mL correlated with sexual dissatisfaction.

Conversely, only among control subjects was there an association between sexual dysfunction and depression as rated by the Beck Depression Inventory, even though HCV was associated with higher depression scores.

Dr. Bini and his associates point out that patients with diabetes, renal failure, prostate cancer, and alcohol abuse were not permitted to participate in the study, so these potential comorbidities cannot explain their findings.

The investigators suggest that abnormalities in the hypothalamic-pituitary-gonadal axis resulting in hypogonadism may be responsible for the sexual dysfunction among their patients

"Based on these findings," the authors suggest that "HCV infection should be considered in the differential diagnosis of sexual dysfunction in men."

Am J Gastroenterol 2006;101:1235-1243.