Sexual dysfunction in males with chronic hepatitis C and antiviral therapy: interferon-induced functional androgen deficiency or depression?
Decrease of libido and erectile dysfunction are reported by male patients during antiviral therapy of chronic hepatitis C, but therapy-associated underlying factors for sexual dysfunction are not well defined. To assess putative contributions of interferon-induced sex hormone changes to sexual dysfunction, we prospectively investigated changes in free testosterone, total testosterone, dehydroepiandrosterone sulfate, prolactin, sex hormone-binding globulin, FSH and LH levels and psychometric self-assessment scores in 34 male patients treated with interferon alfa-2b (5 MIU three times weekly) (n=19)+ ribavirin (n=15) for 6-12 months. Depression was measured by the Hospital Anxiety and Depression Scale. Sexual dysfunction was evaluated by the Symptom Checklist 90 Item Revised and a five-point rating scale assessing sexual arousal disorder. Free and total testosterone decreased significantly during antiviral therapy in close correlation with libido/sexual function. Depression scores increased during therapy and were also significantly associated with sexual dysfunction. However, androgen levels displayed no significant correlation with depression. These results suggest that interferon-induced decrease in sexual function is associated - but not causally related -with both androgen reduction and increased depressive symptoms. These findings may affect care for male hepatitis C patients during interferon therapy.
Kraus
M R
MR
Department of Gastroenterology and Hepatology, Medizinische Poliklinik, University of Würzburg, Klinikstrasse 6-8, D-97070 Würzburg, Germany. kraus_m@klinik.uni-wuerzburg.de
Schäfer
A
A
Bentink
T
T
Scheurlen
M
M
Weissbrich
B
B
Al-Taie
O
O
Seufert
J
J
D000328:Adult; D000704:Analysis of Variance; D000728:Androgens / Q000097:blood*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003863:Depression / Q000150:complications; D007172:Erectile Dysfunction / Q000209:etiology* / Q000378:metabolism / Q000523:psychology; D005640:Follicle Stimulating Hormone / Q000097:blood; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007989:Libido; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D011994:Recombinant Proteins; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D013997:Time Factors
D000728:Androgens; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone