Sexual dysfunction among Egyptian men with chronic hepatitis C in the post elimination era prevalence and associated factors

Abstract

Despite Egypt’s landmark achievement in controlling hepatitis C virus (HCV) and receiving WHO validation on the path to elimination, long-term sequelae among men previously affected by chronic HCV remain under-recognized. Sexual dysfunction is an important yet often overlooked component of survivorship and quality of life in chronic liver disease care. To estimate the prevalence and identify factors independently associated with sexual dysfunction among Egyptian men with chronic HCV, informing post-elimination care strategies. A cross-sectional analysis was conducted on 1,500 adult males attending National Committee for Control of Viral Hepatitis (NCCVH) units across six geographically diverse Egyptian governorates. Sexual health was assessed using the Brief Sexual Symptom Checklist for Men and the International Index of Erectile Function (IIEF-5). Logistic regression was applied to identify factors independently associated with sexual dysfunction. The overall prevalence of at least one form of sexual dysfunction was 72.8%. Erectile dysfunction was most common (59.3%), followed by desire dysfunction (47.5%) and premature ejaculation (32.1%), orgasmic dysfunction (27.8%), and dyspareunia (12.6%). The strongest independent associations clustered around markers of advanced disease severity and complications, particularly hepatocellular carcinoma (DD AOR: 12.39; 95% CI: 4.64–33.09; PE AOR: 8.99; 95% CI: 2.06–39.25) and age ≥ 50 years (DD AOR: 5.00; 95% CI: 3.65–6.85; PE AOR: 7.58; 95% CI: 4.17–13.76). Diabetes mellitus was also strongly associated with erectile dysfunction (AOR: 3.89; 95% CI: 2.07–7.30) and premature ejaculation (AOR: 3.33; 95% CI: 1.72–6.44). Sexual dysfunction is a common, under-recognized sequela among Egyptian men with chronic HCV in the post-elimination era. The strongest independent associations were observed with advanced liver disease/complications and metabolic comorbidity, supporting integration of routine sexual health assessment and counseling into post-HCV follow-up. Survivorship-oriented care is particularly important for patients with advanced liver disease.