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.
Summary
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.
Objectives: The adipose tissue can play active proinflammatory and profibrogenic role in pathogenesis of chronic hepatitis C (CHC). Leptin seems to play important, although not fully elucidated, role in pathogenesis of liver damage.
Aim of the work: to investigate the relationship between serum leptin concentrations and the degree of hepatic fibrosis in patients infected with hepatitis C virus and to assess whether leptin level is affected by the combined antiviral treatment treatment when estimated 12 weeks after the start of treatment.
Patients and methods: 40 patients with CHC together with 10 healthy control subjects were enrolled in the study. Leptin level was estimated in these subjects at baseline and after 12 weeks from the start of combined antiviral therapy. Patients had liver biopsy taken at baseline to determine the fibrosis and inflammation grades according to the METAVIR study, 1994.
Results: Leptin concentration at baseline showed no significant difference between patients and control group (P> 0.05). Leptin level was much higher in female patients (36.1 ± 23.6) than in males (10.4 ± 9.9) (P< 0.05) at baseline group but not in the treated group. A high significant positive correlation was found between serum leptin level, inflammation grades and fibrosis stages (r= 0.810, p < 0.001 & r= 0.791, p < 0.001 respectively). Serum leptin concentrations in patients treated by combined antiviral therapy for 12 weeks is decreased more than baseline group with a mean ± SD of (8.8 ± 11.1 & 14.9 ± 16.3 respectively) although not reaching a statistically significant levels (P=0.054). Conclusion: Leptin has a profibrogenic and/or proinflammatory role as higher leptin levels were correlated with fibrosis stages and inflammation grades in CHC patients. Interferon-alpha antiviral therapy can decrease and suppress leptin levels in CHC patients
