Document Detail

Seminal fluid ribavirin level and functional semen parameters in patients with chronic hepatitis C on antiviral combination therapy.
MedLine Citation:
PMID:  20399525     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Due to the possible teratogenic effect of ribavirin, effective contraception is mandatory during antiviral therapy in patients with chronic hepatitis C (CHC). The aim of this study was to evaluate seminal parameters and ribavirin and HCV-RNA concentrations in seminal fluid and serum prior to and during antiviral treatment.
PATIENTS AND METHODS: Fifteen male patients (age: 42+/-9 (years+/-SD)) with CHC treated with pegylated interferon-alpha-2a and ribavirin were investigated. Seminal fluid (sperm concentration, motility, and morphology) was analysed morphologically. HCV-RNA and ribavirin concentration were determined by quantitative PCR and HPLC, respectively. Examinations were carried out at baseline, week 4, and week 12.
RESULTS: Ribavirin concentration was higher in seminal fluid than in serum (week 4: 5.2+/-2.5 vs. 2.1+/-0.3; week 12: 4.4+/-1.8 vs. 2.0+/-0.3 (microg/ml, mean+/-SD; p<0.001)). Semen abnormalities were common at baseline (asthenoteratozoospermia: n=6; asthenozoospermia: n=3; teratozoospermia: n=3). Sperm density (BL: 67+/-33x10(6)/ml; week 4: 42+/-25 (p<0.05); week 12: 49+/-33 (n.s.)), percentage of sperm with progressive motility (BL: 40+/-26%; week 4: 27+/-25; week 12: 31+/-20 (n.s.)), and percentage of sperm with normal morphology (BL: 25+/-15; week 4: 20+/-11; week 12: 16+/-9; p<0.05 for both) further decreased during antiviral therapy. HCV-RNA was detectable in the seminal fluid of only two patients prior to antiviral therapy and was undetectable in all patients during combination therapy.
CONCLUSION: Semen abnormalities were common in CHC patients, with further impairment during antiviral therapy. Ribavirin concentration was elevated twofold in seminal fluid compared to serum levels, which reinforces the need for contraception during antiviral combination therapy.
Harald Hofer; Josef Donnerer; Kathrin Sator; Katharina Staufer; Thomas-Matthias Scherzer; Clemens Dejaco; Michael Sator; Harald Kessler; Peter Ferenci
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Publication Detail:
Type:  Journal Article     Date:  2010-03-23
Journal Detail:
Title:  Journal of hepatology     Volume:  52     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-08-23     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  812-6     Citation Subset:  IM    
Copyright Information:
Copyright 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Waehringerguertel 18-20, Vienna, Austria.
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MeSH Terms
Antiviral Agents* / administration & dosage,  adverse effects,  pharmacokinetics
Asthenozoospermia / chemically induced*,  pathology
Drug Therapy, Combination
Hepacivirus / genetics,  isolation & purification*
Hepatitis C, Chronic / drug therapy*
Interferon-alpha / administration & dosage
Middle Aged
Oligospermia / chemically induced,  pathology
RNA, Viral / metabolism
Recombinant Proteins
Ribavirin* / administration & dosage,  adverse effects,  pharmacokinetics
Semen / metabolism,  virology
Spermatogenesis / drug effects
Spermatozoa / drug effects*,  pathology
Reg. No./Substance:
0/Antiviral Agents; 0/Interferon-alpha; 0/RNA, Viral; 0/Recombinant Proteins; 36791-04-5/Ribavirin; 76543-88-9/interferon alfa-2a

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