Sexual dysfunction, depressive symptoms, and perceived impact of HBV infectivity among noncirrhotic patients with chronic hepatitis B: a cross-sectional study.

BACKGROUND

Chronic hepatitis B (CHB) remains a major global public health burden, yet sexual health is rarely addressed in routine care. This study aimed to assess the prevalence of sexual dysfunction (SD) and examine demographic, clinical, and psychological factors associated with sexual function among noncirrhotic patients with CHB. We also explored the association between sexual function and the perceived negative impact of HBV infectivity on sexual life.

METHODS

This cross-sectional study was conducted from December 2023 to July 2024, enrolling 657 patients with CHB and 121 non-HBV controls. Patients with CHB were classified by treatment status as receiving pegylated interferon α-2b (n = 391), receiving nucleos(t)ide analogues (n = 203), or not receiving antiviral therapy (n = 63). Sexual function was assessed using the IIEF-5, EHS, and PEDT in men and the FSFI in women. Psychological status was assessed with the PHQ-9 and GAD-7, and the perceived negative impact of HBV infectivity on sexual life was assessed using a single exploratory yes/no item. Hierarchical multiple linear regression was used to identify factors associated with sexual function scores.

RESULTS

The prevalence of SD was significantly higher in all CHB subgroups than in Non-HBV group, with the highest prevalence observed in the IFN-CHB group, both in men (70.9%) and women (70.8%). In multivariable models, older age, IFN-CHB status, and higher PHQ-9 scores were associated with lower sexual function scores in both sexes. Of the variables examined, IFN-CHB status showed the strongest negative association in men (β = -0.267, p < 0.001), whereas PHQ-9 score showed the strongest negative association in women (β = -0.312, p = 0.006). A perceived negative impact of HBV infectivity on sexual life was reported by 21.6% of men and 24.7% of women with CHB. Men reporting this perception had lower IIEF-5 scores (p < 0.001), and women reporting it had lower FSFI scores (p = 0.020).

CONCLUSION

Sexual dysfunction was common among sexually active patients with CHB, and poorer sexual function was associated with IFN-CHB status, depressive symptoms, and the perceived negative impact of HBV infectivity on sexual life. Sexual health assessment and mental health support may therefore have value in comprehensive CHB care.