Desire, Function, and Satisfaction in Men Undergoing Treatment with Interferon-based
Therapy for Chronic Hepatitis C|
therapy for chronic hepatitis C virus (HCV)
infection consisting of pegylated
interferon plus ribavirin is associated with a number of side effects, including
depression and blood cell deficiencies.
At the 59th
Annual Meeting of the American Association for the Study of Liver Diseases (AASLD
2008) last week in San Francisco, researchers reported results of a study
to assess the frequency and severity of sexual dysfunction as a side effect of
Study of Viral Resistance to Antiviral Therapy of Chronic Hepatitis C (VIRAHEP-C)
was a multicenter study of combination therapy in treatment-naive African-American
and Caucasian patients with HCV
A total of 401 participants were enrolled at 8 U.S. centers.
All were treated with 80
mcg/week pegylated interferon alfa-2a (Pegasys) plus 1000-1200 mg/day weight-adjusted
ribavirin. Patients who remained HCV RNA positive after 24 weeks stopped therapy
at that point, while those with undetectable HCV RNA continued treatment through
48 weeks. All were followed for 24 weeks after completion of therapy to determine
sustained virological response (SVR).
sexual health questionnaires were obtained at weeks 0, 4, 12, 24, 48, and 72.
A total of 260 men completed the questionnaire at least once. Five sexual health
questions were used to assess sexual desire, function (erection and ejaculation),
and satisfaction. Standard SF-36 and CES-D scales were used to assess quality
of life and depression.
At baseline, 37% of the men reported impairment
of sexual desire.
26% noted erectile dysfunction and 21%
reported ejaculatory problems.
44% reported moderate or severe dissatisfaction
with their sex life.
During interferon-based therapy, all domains
of sexual health worsened:
Impaired desire to 53%;
Erectile dysfunction to 39%;
Ejaculatory dysfunction to 31%;
Sexual dissatisfaction to 54%.
By the end of 48 weeks of treatment, 51%
of the men reported that their sex life was worse than before therapy.
Initial impairment as well as worsening
of sexual desire, function, and satisfaction were associated with depression.
24 weeks after anti-HCV treatment ended,
most components of sexual health returned to baseline.
However, among men treated for the full
48 weeks, the proportion with erectile and ejaculatory dysfunction remained slightly
higher than at baseline.
on these findings, the authors concluded, "Declines in sexual desire, function
and satisfaction are common side effects of combination antiviral therapy in men."
onset of dysfunction appears within 4 weeks with gradual worsening over time,"
they continued. "Most components of sexual dysfunction resolve within 24
weeks of stopping therapy, but erectile and ejaculatory dysfunction may persist
in a small proportion."
Finally, they recommended, "Education
and counseling regarding the potential of sexual side effects of [pegylated interferon]
and ribavirin therapy is warranted."
Internal Medicine, Columbia
University College of Physicians and Surgeons, New York, NY; New England Research
Institute, Boston, MA; Public Health, University of Pittsburgh, Pittsburgh, PA;
National Institute of Diabetes and Digestive and Kidney Diseases, National Institute
of Health, Bethesda, MD.
Dove, RC Rosen, D Ramcharran, and others. Decline in Sexual Desire, Function and
Satisfaction in Men During Peginterferon and Ribavirin Therapy for Chronic Hepatitis
C. 59th Annual Meeting of the American Association for the Study of Liver Diseases
(AASLD 2008). San Francisco. October 31-November 4, 2008. Abstract 267.