Direct-acting antiviral drugs improve the female sexual burden associated with chronic HCV infection

ABSTRACT

Background: The impact of patient cure by direct-acting antiviral agents (DAAs) on female sexual dysfunction (FSD) associated with HCV hasn’t been studied.

Aim: To study the impact of DAAs on associated FSD in patients with chronic HCV infection.

Methods: In patients with chronic HCV infection who were eligible for DAAs, the self-administered female-sexual-function index (FSFI) questionnaire was completed by 300 sexually active females’ patients before treatment and compared to equal number of age and socioeconomically matched controls. FSFI questionnaire results after treatment were compared to patients’ baseline results.

Results: The mean total score for the patients was significantly lower than that for controls (16.77 ± 1.36 versus 17.52 ± 0.99, P < 0.001). Patients after treatment with DAAs significantly scored better results than baseline results in the total score and all domains of the questionnaire and significantly less patients had FSD compared to baseline (2.7% versus 29.3% P < 0.05). Patients’ mean FSFI score significantly improved after cure (18.8 ± 0.27 vs. 16.77 ± 1.36, P < 0.001).

Conclusion: Hepatitis C has negative impacts on FSF and affecting all domains of FSFI. The DAAS improve the sexual burden associated with hepatitis C in patients who achieved sustained virologic response.

KEYWORDS:

• HCV
• hepatitis C
• directly acting antiviral drugs
• sexual dysfunction
• female sexual function index

Article highlights

• There are only few studies addressed the sexual function and pegylated interferon-based therapy in women with chronic HCV infection and no studies discussed the impact of direct-acting antiviral drugs (DAAs) on female sexual function

• This study examined female sexual dysfunction (FSD) in women with chronic hepatitis C virus (HCV) infection, we found that DAAs significantly improved the sexual dyfunction associated with chronic HCV infection.

• Therefore, our study have clinical implications in the treatment of women with female sexual dysfunction. Considering this, we believe that our study will make a significant contribution to the literature.

• The high tolerability, potency and safety of DAAs encourage us to give more social, and educational support for patients to cope with hepatitis C virus stigmatizations and its socio-economic burdens for proper medical management.

• Finally, for a better quality of life, it is important to change the practices and perceptions of patients’ husbands toward a better sexual life, especially with the wide availability of safe and potent DDAs to treat chronic HCV infection

Acknowledgments

The authors would like to thank all support staff in outpatients’ clinics-National Liver Institute-Menoufia University for their help and support

Author Contributions

Substantial contributions to conception and design: Esam Elshimi, Neamat Sakr, Wesam Morad and Noha Mohamad. Acquisition of data Esam Elshimi, Noha Mohamad, Neamat Sakr, and Wesam Morad and Imam Waked. Drafting the article and revising it critically for important intellectual content; Esam Elshimi, Noha Mohamad and Imam Waked. Final approval of the version: Esam Elshimi, Noha Mohamad, Wesam Morad and Imam Waked. All the authors have read and approved the manuscript.

Ethical approval and consent

The study was conducted in accordance with the Declaration of Helsinki and the protocol was approved by the ethics committee (for medical research) of Würzburg University and by the Institutional Review Board of the National Liver Institute, Menoufia University (IRB number IRB00003413) in May 2016. An informed written Arabic consent form was signed by every participant in the presence of one of the authors. The consent form stated that the answers of questionnaire would be anonymous and the obtained results would be used only for the current study and to be used only for scientific purposes.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.