The impact of chronic hepatitis B and chronic hepatitis C on sexual function: a systematic review and meta-analysis

INTRODUCTION: Several studies have identified an association between chronic hepatitis B (CHB), chronic hepatitis C (CHC), and an elevated risk of sexual dysfunction (SD). However, no systematic review or meta-analysis has been conducted to investigate this relationship. OBJECTIVE: This study aimed to provide an overview of the prevalence of SD and its associated risk factors in patients with CHB and/or CHC. METHODS: Databases including EMBASE, MEDLINE, and the Cochrane Library, were systematically searched from their inception until June 14, 2023, to identify studies that reported SD in CHB and CHC patients. Subgroup analysis, meta-regression, and sensitivity analysis were employed to detect potential sources of bias. RESULTS: Out of 734 identified records, 18 studies (encompassing 2,898 patients, 77.6% of whom were men, with a mean age ranging from 36 to 59 years) were included to calculate the overall pooled prevalence of SD. The prevalence of SD was found to be 47.8% (95% CI: 33.9%-61.9%, I2 = 98.4%, p < 0.001) among patients with CHB and/or CHC. Subgroup analysis, meta-regression, and sensitivity analysis did not reveal any potential sources of bias. The prevalence of SD was 56.9% (95% CI: 40.1%-73.0%, I2 = 94.7%, p < 0.001) in women and 44.4% (95% CI: 28.1%-61.4%, I2 = 98.5%, p < 0.001) in men. Synthesis of the data showed that CHB and CHC were significantly associated with an increased risk of developing SD in both sexes (RR = 3.58, 95% CI: 2.76–4.66, I2 = 82.5%, p < 0.001). Hepatitis C virus (HCV) infection (OR: 4.30, 95% CI: 2.74–6.74, I2 = 0.0%, p = 0.397) and depression (OR: 1.51, 95% CI: 1.31–1.75, I2 = 48.3%, p < 0.001) were identified as risk factors for SD in men, and HCV infection (OR: 7.57, 95% CI: 4.16–13.77, I2 = 0.0%, p = 0.747) was also identified as a risk factor for SD in women. CONCLUSION: The prevalence of SD in patients with CHB and/or CHC is notably high, and the risk of SD increases in both male and female patients with CHB and CHC.