Sexual impairment is common among men with chronic hepatitis C undergoing antiviral therapy, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.
This is the first time a study evaluating the combination therapy, peginterferon and ribavirin, has identified sexual dysfunction as a side effect. Sexual dysfunction and impairment of desire should be considered common side effects of combination antiviral therapy in men with hepatitis C. It has the potential to affect all three components of sexual health: desire, function and satisfaction.
Before therapy, 37 percent of men reported at least some degree of impairment in sexual desire, while 44 percent reported dissatisfaction with their sexual life. In addition, 22 percent reported impairment in erectile and 26 percent in ejaculatory function. The average onset of sexual dysfunction appeared to be within four weeks of starting antiviral therapy, and many patients reported a gradual worsening over time. At the end of therapy (24 or 48 weeks), an estimated 38 percent to 48 percent of men reported that overall sexual function was worse than before treatment. African Americans reported less impairment in sexual desire and satisfaction than Caucasian Americans during therapy. While most components of sexual health evaluated in this study resolved within six months after the cessation of therapy, erectile and ejaculatory function remained slightly worse than before therapy in a proportion of men who received a full 48 weeks of treatment.
As part of the Study of Viral Resistance to Antiviral Therapy of Chronic Hepatitis C (VIRAHEP-C), 260 men treated with peginterferon alfa-2a and ribavirin completed self-administered questionnaires concerning sexual desire, sexual function — including erectile and ejaculatory function — and sexual satisfaction before, during and after treatment.
Chronic hepatitis C affects 1 percent to 2 percent of the American population and is more common among African Americans than Caucasian Americans and other racial and ethnic groups in the U.S. While current therapies for hepatitis C are evolving, at present they remain only partially effective.
Though sexual function and health are important elements of quality of life and overall well-being, they are infrequently mentioned in the discussion of complications of therapy with peginterferon and ribavirin. In fact, most review articles on hepatitis C treatment, summary publications on the side effects of therapy and the package inserts for peginterferon do not mention sexual dysfunction as a potential complication of therapy.
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