Seminal fluid ribavirin level and functional semen parameters in patients with chronic hepatitis C on antiviral combination therapy

Hofer, Harald; Donnerer, Josef; Sator, K.; Staufer, Katharina; Scherzer, Thomas–Matthias; Dejaco, Clemens; Sator, Michael; Kessler, Harald H.; Ferenci, Péter

doi:10.1016/j.jhep.2009.12.039

Cited by 42 publications

(32 citation statements)

References 25 publications

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“…Chronic hepatitis C may impair male fertility at the level of the testis by decreasing cFT and inhibin B levels, impairing semen quality (15). A positive correlation between serum viral load and hepatitis C virus concentration in semen has been suggested (16) but is as yet unproven. Successful antiviral treatment improves spermatogenesis (15), but combining pegylated interferon-alpha with ribavirin, as given to our patient, may worsen hepatitis C–induced infertility.…”

Section: Discussionmentioning

confidence: 99%

Successful Fertility Restoration after Allogenic Hematopoietic Stem Cell Transplantation

et al. 2014

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Objective Myeloablative conditioning regimens given prior to hematopoietic stem cell transplantation (HSCT) frequently cause permanent sterility in men. In patients with sickle cell disease (SCD) we use a nonmyeloablative regimen with sirolimus, alemtuzumab, and low-dose total-body irradiation (300 centigrays) with gonadal shielding preceding allogeneic HSCT. We report here the restoration of azoospermia in a patient with SCD after allogeneic HSCT. We discuss the impact of our patient’s underlying chronic medical conditions and the therapies he had received (frequent blood transfusions, iron chelating drugs, ribavirin, hydroxyurea, opioids), as well as the impact of the nonmyeloablative conditioning regimen on male gonadal function, and we review the literature on this topic. Methods We determined the patient’s reproductive hormonal values and his semen parameters before, during, and after HSCT and infertility treatment. In addition, we routinely measured his serum laboratory parameters pertinent to SCD and infertility, such as iron and ferritin levels. A karyotype analysis was performed to assess the potential presence of Klinefelter syndrome. Finally, imaging studies of the patient’s brain and testes were done to rule out further underlying pathology. Results A 42-year-old man with SCD, transfusional iron overload, and hepatitis C underwent a nonmyeloablative allogeneic HSCT. One year later he desired to father a child but was found to be azoospermic in the context of hypogonadotropic hypogonadism. Restoration of fertility was attempted with human chorionic gonadotropin (2,000 IU) plus human menopausal gonadotropin (75 IU follicle-stimulating hormone) injected subcutaneously 3 times weekly. Within 6 months of treatment, the patient’s serum calculated free testosterone value normalized, and his sperm count and sperm motility improved. After 10 months, he successfully initiated a pregnancy through intercourse. The pregnancy was uncomplicated, and a healthy daughter was delivered naturally at term. Conclusion Despite exposure to several gonadotoxins, transfusional iron overload and nonmyeloablative conditioning with radiation causing severe testicular atrophy suggesting extensive damage to seminiferous tubules and possibly Leydig cells, gonadotropins were efficacious in restoring our patient’s reproductive capability.

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Section: Discussionmentioning

confidence: 99%

Successful Fertility Restoration after Allogenic Hematopoietic Stem Cell Transplantation

et al. 2014

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“…Durazzo et al (5) reported that the sperm concentration between controls and HCV patients was different, suggesting a possible negative influence of HCV on spermatogenesis. Moretti et al (4) added that sperm concentration was reduced in 5 (38.5%) out of 13 of their HCV patients in their study; Hofer et al (9) and Lorusso et al (6) also reported low sperm concentration in most or all of their chronic HCV patients compared with fertile controls. Safarinejad et al (10) also showed that in HCV patients the mean total sperm count, motility, and normal morphology were significantly lower than in controls.…”

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confidence: 88%

“…Zignego and Brechot (13) and Hofer et al (9) also reported a significant impairment in progressive sperm motility and normal sperm morphology. Durazzo et al (5) associated reduced sperm motility and sperm normal morphology in these patients with significantly lower levels of free serum testosterone and inhibin B.…”

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confidence: 92%

Semen and hormonal parameters in men with chronic hepatitis C infection

Hofny

Ali

Taha

et al. 2011

Fertility and Sterility

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“…Other side effects associated with ribavirin include mild lymphopaenia, hyperuricaemia, itching, rash, cough and nasal stuffiness. Furthermore, significant teratogenic and/or embryocidal effects have been observed in all animal species exposed to ribavirin except for baboons [67] Consequently, ribavirin is contraindicated in both males and females who are attempting conception with a recommended 6-month washout period before trying to get pregnant [70,71]. …”

Section: Introductionmentioning

confidence: 99%

The Application and Mechanism of Action of Ribavirin in Therapy of Hepatitis C

Thomas

Ghany

Liang

2012

Antivir Chem Chemother

132

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Ribavirin has been used as an antiviral agent for several decades. Although it has activity against numerous viruses, its major use clinically has been in the treatment of respiratory syncytial virus in paediatric patients and chronic HCV infection in both children and adults. This review highlights the clinical application and mechanism of action of ribavirin and discusses the future role of ribavirin in treatment of HCV where there are intense research efforts to improve therapy.

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Seminal fluid ribavirin level and functional semen parameters in patients with chronic hepatitis C on antiviral combination therapy

Cited by 42 publications

References 25 publications

Successful Fertility Restoration after Allogenic Hematopoietic Stem Cell Transplantation

Successful Fertility Restoration after Allogenic Hematopoietic Stem Cell Transplantation

Semen and hormonal parameters in men with chronic hepatitis C infection

The Application and Mechanism of Action of Ribavirin in Therapy of Hepatitis C

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