Objective: To study the effect of entecavir on the reproductive function of male patients with chronic hepatitis B (CHB).
Methods: This study included 56 CHB male patients (aged 18－45 ［33.14 ± 5.38］ years) initially treated with entecavir at 0.5 mg/d for 24 weeks from 2015 to 2018 and another 24 healthy fertile male volunteers (aged 21－45 ［32.62 ± 5.94］ years) as normal controls. We obtained the body mass index (BMI), reproductive hormone levels, semen parameters and IIEF-5 scores from the subjects and compared them between the two groups before and after treatment.
Results: There were no statistically significant differences between the CHB and normal control groups in age, BMI, lifestyle and baseline reproductive hormone levels except in the levels of FSH (［3.92 ± 1.29］ vs ［3.08 ± 0.85］ mIU/ml, P = 0.003) and E2 (［35.79 ± 7.49］ vs ［28.25 ± 7.09］ pg/ml, P < 0.01). The semen parameters were significantly lower in the CHB patients than in the normal controls, including total sperm motility (［37.75 ± 13.33］% vs ［49.58 ± 9.27］%, P = 0.004), the percentage of progressively motile sperm (PMS) (［30.70 ± 10.03］% vs ［42.46 ± 8.90］%, P < 0.01), sperm concentration (［51.51 ± 19.50］ vs 70.33 ± 30.62) ×10⁶/ml, P = 0.007), and total sperm count (［160.2 ± 51.8］ vs ［225.91 ± 97.97］ ×106, P = 0.002), and so were the IIEF-5 scores (19.32 ± 2.34 vs 21.25 ± 2.35, P = 0.0006). After 24 weeks of entecavir treatment, the CHB patients showed no significant difference from the baseline in the semen volume, semen pH and days of abstinence, but remarkable improvement in total motility (［37.75 ± 13.33］ vs ［44.1 ± 11.89］%, P = 0.004), PMS (［30.70 ± 10.03］ vs ［38.30 ± 7.42］%, P < 0.01), sperm concentration (［51.51 ± 19.50］ vs ［62.00 ± 24.64］ ×10⁶/ml, P = 0.007), total sperm count (［160.21 ± 51.8］ vs ［207.65 ± 81.69］ ×106, P = 0.0002), and IIEF-5 score (20.13 ± 1.82 vs 19.32 ± 2.34, P = 0.02).
Conclusions: CHB patients have lower sexual function and semen quality than normal males. Entecavir can significantly improve the liver function, sexual function and semen quality of the CHB patients, but whether it directly improves the sexual function and semen quality of the patients or indirectly through liver function improvement needs to be further studied.
Keywords: antiviral therapy; entecavir; semen quality; chronic hepatitis B.