title: Anti-Viral Therapy and Decreased Sexual Desire in Patients with Chronic Hepatitis C.
abstract: OBJECTIVE
  Peg-interferon (PegIFN)α2a or PegIFNα2b plus ribavirin (RBV) is the standard therapy for chronic hepatitis C virus (HCV) infection in Taiwan and Asia. It is commonly associated with adverse effects, but the issue of sexual and mental health is not well reported. This study aimed to evaluate the impact of anti-viral therapy with PegIFNα plus RBV on sexual desire and depression.
  
  
  METHODS
  This prospective cohort study from 2009 to 2014 enrolled 181 patients with HCV who received PegIFNα2a (180 mcg/week) or PegIFNα2b (1.5 mcg/Kg/week) plus RBV (800-1200 mg/day) according to response-guide therapy for 24 to 48 weeks in a tertiary medical center. Patients with decreased sexual desire (DSD) before PegIFNα plus RBV were excluded. Patients were evaluated at baseline (week 0) and after 2, 4, 8, 12, 16, 20, and 24 weeks of PegIFNα plus RBV treatment using the structured Mini-International Neuropsychiatric Interview, for the diagnosis of a major depressive episode, and the 21-item Beck Depression Inventory (BDI), for monitoring depressive symptoms. The 21st item of the BDI was used to evaluate DSD.
  
  
  RESULTS
  During therapy, 124 (68.5%) patients had DSD. The BDI score peaked at 14.8 weeks. The severity of DSD was greatest at 16 weeks of treatment. The average score of the 21st item of the BDI correlated with DSD. Depression history and the prevalence of subsequent major depressive disorder after anti-viral therapy was correlated to DSD (p = 0.05 and 0.001). Male patients complained of DSD more significantly than females (p = 0.031).
  
  
  CONCLUSIONS
  Decreased sexual desire is common but is usually neglected in patients with chronic hepatitis C undergoing anti-viral therapy, especially among male patients. Physicians must be monitoring the side effects of sexual health and depression.
authors: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors: Po-Jen
authors: http://orcid.org/0000-0002-0989-7876
authors: PJ
authors: Hsiao
authors: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors: Po-Fan
authors: PF
authors: Hsieh
authors: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors: Eric Chieh-Lung
authors: EC
authors: Chou
authors: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, Taichung, Taiwan.|Division of Hepato-gastroenterology, department of internal medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Hsueh-Chou
authors: HC
authors: Lai
authors: Division of Hepato-gastroenterology, department of internal medicine, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
authors: Cheng-Yuan
authors: CY
authors: Peng
authors: Department of Psychiatry, & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.
authors: Kuan-Pin
authors: KP
authors: Su
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012256:Riboflavin / Q000009:adverse effects / Q000627:therapeutic use; D012725:Sexual Behavior / Q000187:drug effects* / Q000523:psychology*
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a; D012256:Riboflavin