The team investigated erectile dysfunction in patients with hepatitis C virus (HCV) infection, and reported their results in the Journal of the American Medical Association.
A total of 207 patients with HCV infection (identified by serum anti-HCV antibodies and HCV RNA) were included in the study.
Of these, 105 had chronic hepatitis and 102 had HCV-associated cryoglobulinemic vasculitis.
All patients were asked to complete the International Index of Erectile Failure (IIEF).
Those with erectile dysfunction based on this evaluation underwent nocturnal penile tumescence testing for 3 nights.
The researchers also measured serum hormone levels, including total and free testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, and estradiol-17 beta in all patients.
|Proportion with erectile dysfunction:|
| Journal of the American Medical Association |
Finally, the prevalence of erectile dysfunction in the patients was compared with its occurrence in 207 control subjects. These age-matched men were selected from a larger group of 2010 Italian men, previously investigated for complaints of erectile dysfunction.
Erectile dysfunction was diagnosed in 39% of HCV-positive patients and in 14% of control subjects, on the basis of IIEF score and nocturnal penile tumescence testing.
Erectile dysfunction was found to be more common in patients with cryoglobulinemic vasculitis than in those with chronic HCV infection (44% vs 33%), although this difference was not statistically significant.
Plasma levels of total and free testosterone were generally lower in HCV-positive patients. However, they were significantly lower in patients with erectile dysfunction versus those without.
In addition, neither erectile dysfunction nor testosterone level was significantly correlated with the severity of liver involvement, as defined on the basis of ultrasound examination and laboratory tests.
Dr Clodoveo Ferri, of the University of Pisa, concluded on behalf of fellow colleagues, "We found that hepatic failure and interferon alfa therapy were unrelated to erectile dysfunction, thus suggesting that chronic HCV infection itself may play a causal role.
"Given the increasing prevalence of HCV, the possibility of HCV infection should be considered in the differential diagnosis of erectile dysfunction."