Improvement of sexuality after hepatitis C cure with direct acting antivirals

Abstract

Despite rarely assessed, sexuality is a relevant domain in Quality of Life. We prospectively evaluated the impact of direct‐acting antiviral therapy on sexuality in a cohort of 186 patients with chronic hepatitis C (HCV). Sexual dysfunction was assessed by validated scales CSFQ‐14/CSFQ‐VAS at baseline and one year after treatment finalization. Median age was 55 years and 87% had mild liver disease. Basal prevalence of sexual dysfunction (62%) and fear of HCV transmission (25%) were high. After HCV cure, both sexual dysfunction prevalence and CSFQ‐VAS improved (P = .058 and P < .01, respectively), and fear of HCV transmission dropped to 16% (P = .02). These changes were especially relevant in young men (<55), where sexual dysfunction decreased from 48.6% to 29.7% (P = .04) and among non‐depressed patients in whom sexual dysfunction decreased from 54.6% to 47% (P < .01). Age and major depression remained as independent factors of sexual dysfunction persistence after HCV cure. Our data suggest that HCV eradication is associated with an improvement in sexuality, in those patients without depression.

Peripheral neuropathy after viral eradication with direct‐acting antivirals in chronic HCV hepatitis: A prospective study

“…A new era in the natural history of HCV infection started in 2013 with the introduction of DAA, achieving approximately 95% viral eradication rate with reduced side effects compared to previous treatments 14,37 . In our study, approximately 1 year after recruitment, DAA‐induced viral eradication significantly improved all neurological scores, in terms of neuropathic pain, impairment, disability and even normalized electrophysiological alterations in 4 patients, independently of clinical and liver disease characteristics, as shown by recent studies assessing the effects of DAAs in other extrahepatic complications 16,17,38 . Moreover, a trend of increase of both motor and sensory nerve amplitudes was detected in the whole subgroup of patients with altered electroneurography at recruitment, however reaching or approaching statistical significance only for a few electroneurographic parameters.…”

“… 14 , 37 In our study, approximately 1 year after recruitment, DAA‐induced viral eradication significantly improved all neurological scores, in terms of neuropathic pain, impairment, disability and even normalized electrophysiological alterations in 4 patients, independently of clinical and liver disease characteristics, as shown by recent studies assessing the effects of DAAs in other extrahepatic complications. 16 , 17 , 38 Moreover, a trend of increase of both motor and sensory nerve amplitudes was detected in the whole subgroup of patients with altered electroneurography at recruitment, however reaching or approaching statistical significance only for a few electroneurographic parameters. On the contrary, no increase in nerve conduction velocity was detected, possibly reflecting axonal re‐growth preceding myelination.…”

“…8,41 There is a growing body of literature on the association between HCV infection and reduced quality of life, impacting all aspects of function. 3,38,42 Cognitive impairment, fatigue, depression, independently of risk behaviours, have the greatest weight. In our study, viral eradication with well tolerated DAAs, improved quality of life, possibly in relation to improved neurological function, as assessed by evaluation of mobility, self-care, usual activities, pain or discomfort, anxiety and depression.…”

“…There is a growing body of literature on the association between HCV infection and reduced quality of life, impacting all aspects of function 3,38,42 . Cognitive impairment, fatigue, depression, independently of risk behaviours, have the greatest weight.…”

Impact of sofosbuvir/ledipasvir versus sofosbuvir/daclatasvir regimens on the male sexual function of patients with chronic hepatitis C

“…Sexual dysfunction is commonly associated with hepatitis C virus infection. The negative impact of HCV infection on sexual function is associated with a poor quality of life (QoL) [10]. Sexual dysfunction was observed to be an infrequent side effect of pegylated interferon and ribavirin therapy [11].…”