Hamdy M. Moustafa 1, Abdel-Wahab Fathy Aly 2. Abdel Rahman A. Alsied 3, Khaled A. Eid4, Mona M. Abdel Mageed Soliman 5, and Bahgat Kamal Abdel Latif6
1,2,4: Hepatology and Gastroenterology Department, .Faculty of Medicine – Al-Azhar University – Assiut . 3,5: Clinical Pathology Department, Faculty of Medicine – South Valley University.
Objectives: HCV infection has a direct effect on semen parameters. The nucleoside analogue ribavirin has been evaluated in combination with interferon alpha-2b, and this combination of antiviral agents has marked effect on semen parameters. Aim of the work: evaluation of the seminal parameters (nemaspermic concentration, motility and morphology) in subjects with chronic HCV-related hepatitis before and after twelve weeks of standard combined antiviral therapy (peg-interferon plus ribavirin), and its correlation with the HCV viral load before the start of treatment in order to verify the possible influences of the virus and/or antiviral treatment on seminal parameters.
Patients and Methods: Fifty male patients with CHC (mean age ± SD = 37.9 ± 8.2 years) treated with peg-interferon-alpha-2a and ribavirin were included in this study. Seminal fluid was analyzed morphologically (nemaspermic concentration, motility, and morphology) and HCV-RNA were carried out at baseline and after week 12 from the start of treatment.
Results: Spermiogram at baseline was (Normozoospermia: n=25; Asthenozoospermia: n=1; Teratozoospermia: n=1; Oligozoospermia: n=1; Oligoasthenoteratozoospermia: n=9; Oligoasthenozoospermia: n = 5; Oligoteratozoospermia: n=5 and Asthenoteratozoospermia: n=3) and after weak 12 (Normozoospermia: n=8; Asthenozoospermia: n=16; Teratozoospermia: n=0; Oligozoospermia: n=0; Oligoasthenoteratozoospermia: n=19; Oligoasthenozoospermia: n=3; Oligoteratozoospermia: n=1 and Asthenoteratozoospermia: n=3). Sperm count was (47.1±27.7) at baseline vs (27.7±18.2) at weak 12. Abnormal forms were (34.9±17.9) at baseline vs (55.2±23.7) at weak 12. As regard motility; grade A was (27.0±9.0) at baseline vs (13.9±5.7) at weak 12. Grade B motility was (24.6±7.0) at baseline vs (14.7±6.6) at weak 12. Grade C motility was (22.9±8.0) at baseline vs (32.4±8.0) at weak 12. Grade D motility was (25.3±8.8) at baseline vs (39.0±12.0) at weak 12. There was a significant negative correlation between HCV viral load and grade A motility (P=0.013) and a significant positive correlation with grade D motility (p=0.006).
Conclusion: Semen abnormalities were found in CHC patients, with further impairment during antiviral therapy which reinforces the use of contraception during antiviral combination therapy.