الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
HCV infection is a major public health problem worldwide. The seroprevalence of CHC in the general population ranges between 0.2 and 2%. CHC is the leading cause of cirrhosis, HCC, and is associated with substantial mortality.
CHC infection causes substantial morbidity due to disabling symptoms, such as fatigue and depression, as well as extrahepatic manifestations. CHC has been associated with numerous extrahepatic disorders and autoimmune diseases, including glomerulonephritis, essential mixed cryoglobulinemia, PCT, polyarteritis nodosa, and others.
CHC infection has also been associated with several endocrine disorders, including autoimmune thyroid disease and DM. In addition to these endocrine disorders, limited available data suggest that HCV infection may be associated with SD.
Sexuality is an important aspect of life, sexual functioning of CHC patients received very limited attention. On the other hand, since psychosocial influences and pathological consequences of HCV might hamper sexual functioning in HCV-infected patients, it is very important to understand the possible associations between HCV and SD.
Any chronic illness may be associated with SD. This is particularly true for CHC, since it is so often associated with fatigue and depression, each of which can contribute to a decreased interest in sex. In addition, medications used in the treatment of CHC, particularly interferon, may cause SD and decreased libido. SD is also a common side effect of many of the antidepressant medications often used to treat the depression and anxiety which arise from treatment with interferon and ribavirin.
Another possible potential reason for SD among HCV-infected men is an abnormality of one or several components of the hypothalamic-pituitary gonadal axis. It is well-known that hypogonadism may be associated with SD in men without liver disease. Alcoholic cirrhosis, hemochromatosis, and other causes of advanced cirrhosis may also cause hypogonadism, or may result in SD because of an abnormal androgen to estrogen ratio. However, little is known about gonadal steroid levels in men with CHC infection who do not have advanced cirrhosis.
Although SD has been reported in patients with HCV infection, little is known about this association. The aims of this study were to determine the prevalence of SD among men with CHC infection. Additionally, correlations
between SD and sociodemographic and biological variables and to evaluate the impact of SD on HRQoL.
This study included 100 CHC patients (50 with compensated cirrhosis and 50 patients without cirrhosis) and 50 healthy controls. All studied individuals were subjected to history taking and clinical examination. Several biochemical parameters that might interfere with sexual function were assessed in this work. These parameters included, ALT, AST, GGT, ALP, BIL, ALB, HB, platelets count, PT, serum free testosterone and serum prolactin.
Intracorporeal injection was done to HCV positive patients and to members of control group complaining of ED. All patients were asked to complete the questionnaire of IIEF and SF-36 questionnaire.
The result of this work showed the following:
1- CHC patients had significantly more SD than controls subjects across all five domains of the IIEF. In addition, no difference was found between the two subgroups of patients in all domains.
2- Psychogenic ED was significantly higher in CHC patients than controls.
3- Duration of HCV was the only significant sociodemographic variable between patients with SD and those without SD in the two subgroups of patients, while other sociodemographic variables like age, level of education, smoking and alcoholism were not significantly different.
4- ALT and AST were the only significant biologic variables between patients with SD and those without SD in the two subgroups of patients, while other biologic variables like ALP, GGT, HB, PT, platelets count, BIL, ALB, free testosterone and serum prolactin were not significantly different.
5- In all sociodemographic variables, there were significant correlations between SD and age and duration of HCV, indicating the importance of these two items in SD.
6-In all biologic variables, there was no significant correlations between SD and all biologic variables.
7-CHC patients with SD scored significantly worse in seven of eight domains of HRQoL as compared with CHC patients without SD with no significant difference in all eight domains of SF-36 between the two subgroups of patient.
Conclusion:
SD is highly prevalent in men with chronic HCV infection. Furthermore, HRQoL was significantly worse in CHC patients with SD than in those with normal sexual function. Based on these findings, HCV infection should be considered in the differential diagnosis of SD in men. Additional studies are needed to determine the pathophysiologic mechanisms underlying the association between CHC infection and SD, and to evaluate the impact of HCV eradication on sexual function.