Sexual quality of life is impaired in patients with chronic hepatitis C

Abstract

Chronic hepatitis C (CHC) patients often have altered quality of life. Few data are available about sexual impairment (SI) in CHC. From 2011 to 2013, we included consecutive CHC outpatients. Exclusion criteria were: antiviral therapy, co-infection, age <18 or >75, transplantation, alcohol consumption, Eastern Cooperative Oncology Group >1. Non-CHC subjects were healthy blood donors. Sexual questionnaires for men and women were adapted from the International Index of Erectile Function and Female Sexual Function Index, respectively, and concerned the past 30 days. Two hundred eighty-one patients were compared with 1086 blood donors. SI was more frequent in CHC patients. Men with CHC had worse desire, confidence, erections, climax and satisfaction (P<0.001). Women with CHC had worse desire, arousal, climax, satisfaction, lubrication and comfort (P<0.001). In multivariate analysis, factors associated with SI in men were CHC (odds ratio (OR)=4.45, 95% confidence interval (CI) 2.46-8.06), age (OR=1.06, 95% CI 1.03-1.09), no intercourse (OR=8.74, 95% CI 4.65-16.04) and unemployment (OR=2.14, 95% CI 1.16-3.95). Factors associated with a worse global sexual life in women were CHC (OR=7.96, 95% CI 4.07-15.58) and no intercourse (OR=21.39, 95% CI 11.03-41.48). The study results were corroborated by propensity score-matching analysis. Sexual life is impaired in men and women with CHC. In clinical practice, sexual quality of life should be evaluated and treated.

Erectile dysfunction in cirrhosis is impacted by liver dysfunction, portal hypertension, diabetes and arterial hypertension

“…[14][15][16]26 In chronic hepatitis, the prevalence ranged between 9% and 78% 15,26 with most studies reporting prevalence rates around 40%-50%. 16,17,[43][44][45] Hence, it seems that once cirrhosis develops, the prevalence of ED is high irrespective of aetiology and this is also confirmed by our data. To our best knowledge, only 2 studies investigated ED in non-alcoholic fatty liver disease and found a prevalence of 45% 46 and 67.5% 47 respectively.…”

“…The prevalence of ED in alcoholic cirrhosis is described with 50%‐70% and with 40%‐92% in viral cirrhosis . In chronic hepatitis, the prevalence ranged between 9% and 78% with most studies reporting prevalence rates around 40%‐50% . Hence, it seems that once cirrhosis develops, the prevalence of ED is high irrespective of aetiology and this is also confirmed by our data.…”

“…Another study found no difference in the prevalence of ED between patients with chronic viral hepatitis vs patients with established cirrhosis. In a French study, prevalence of sexual impairment in 146 men with chronic hepatitis C (HCV) was 39.7% compared to 6.5% in healthy controls. Multivariate analysis found the presence of HCV infection, age, no sexual intercourse and unemployment as independent predictors of sexual impairment.…”

Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

“…There is a large body of literature suggesting that those living with hepatitis C have a lower quality of life than the general population . Reduced health‐related, general and sexual quality of life have all been reported among people living with hepatitis C (measured by the Sickness Impact Profile, World Health Organization Quality of Life Assessment Brief scale, adaptations of the International Index of Erectile Function and Female Sexual Function Index respectively). Other metrics have also been used to highlight the impact of hepatitis C on patient‐report outcomes.…”

A Qualitative Study on Marital Challenges of Chronic Hepatitis B Patients

“…On the contrary, there is a lack of qualitative researches on reporting sexual health of males and females with chronic diseases that consider their subjective experiences (17). Because a few studies exist on marital problems in patients with chronic hepatitis C (18)(19)(20), knowledge on marital problems of HBV carriers is limited. As hepatitis B infection is a confidential and unparalleled experience, to have a detailed understanding of the patients' marital challenges, which are the most confidential secrets of private life, using a qualitative approach will be helpful.…”