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Abstract
This study has been carried out to assess the sexual problem and the prevalence of erectile dysfunction in patients with chronic compensated hepatitis C infection by means of five items version of International Index of Erectile Function (IIEF-5), to explore the erectile dysfunction relevance to patients’ clinical profile and its relation to depression.
The study included seventy five patients with chronic compensated hepatitis C infection who were selected from the in patients of Tropical Medicine Department, Ain Shams University Hospital, Cairo Transport Authority (CTA) hospital and outpatient clinics and twenty five healthy controls.
All patients and controls were subjected to medical and sexual histories taking. Their physical examinations and genitourinary examinations were carried out. Blood samplings were taken for complete blood picture, erythrocyte sedimentation rate (ESR), liver profile including alanine aminotransferase(ALT), aspartate aminotransferase(AST), total serum bilirubin, direct serum bilirubin, serum albumin, viral serology analysis including serum anti- HCV antibodies and hepatitis B surface antigen, fasting blood glucose, 2 hours post prandial blood glucose, renal profile and cryoglobulin test for patients. All patients and control groups were asked to complete five items version of International Index of Erectile Function questionnaire (IIEF-5) and The Beck Depression Inventory questionnaire (BDI). All patients were asked to undergo abdominal ultra sound examination.
We assessed erectile dysfunction in our patients by using the 5-items version of the International Index of Erectile Function (IIEF-5) questionnaire and our results showed that 42(56%) had normal scores on the IIEF-5, 17 (22.7%) had mild erectile dysfunction, 12(16%) had mild to moderate erectile dysfunction, and 4(5.3%) had moderate erectile dysfunction. This is significantly different from control subjects in whom 18(72%) had normal scores on the IIEF-5, 6(24%) had mild erectile dysfunction, and 1(4%) had moderate erectile dysfunction.
Regarding prevalence of depression among 75 HCV positive patients, we found that 39 (52%) had normal scores on the Beck Depression Inventory (BDI) score and 37(48%) had depression score classified as following, 15 (20%) had mild mood disturbance, 11(14.7%) had borderline clinical depression, 8 (10.7%) had moderate depression, and 2 (2.6%) had severe depression. This is significantly different from control subjects in whom 15 (60%) had normal scores and 10(40%) had depression score classified as following, 6 (24%) had mild mood disturbance, 3(12%) had borderline clinical depression, and 1 (4%) had moderate depression.
Regarding correlation between ED score and depression score in cases, it was found that inverse correlation between ED score and depression score in cases (t = -0.61, P<0.05).
The present study also showed that there is inverse highly significant correlation between age and erectile function score among cases (sexual dysfunction increases with age) (r=-0.48, p <0.01).
Regarding correlation between age and depression score in cases, it was found that positive highly significant correlation versus age, among cases and controls by using Speraman correlation (in cases r=0.28, p <0.05, in controls r=0.50, p <0.01).
As regards relation between depression and ED levels versus smoking among cases, it was found that no significant association between smoking versus, erectile dysfunction and depression by using chi-square test.
In the present study it was found that the cryoglobulin positive patients were 15 patients (20%) among 75 patients with hepatitis C infection.
As regards relation between ED levels versus cryoglobulin among cases it was found that highly significant association between positive cryoglobulin and erectile dysfunction by using chi-square test ( X2 =1.5, P<0.01).
As regards drug intake (Sildinafill), the studied cases had more frequent drug intake (21 cases 28%) compared to control group (2 controls 8%) with statistically highly significant difference in between by using chi-square –test ( X2 =5.4, P<0.01).