Sperm output in patients with primary infertility and hepatitis B or C virus; negative influence of HBV infection during concomitant varicocele.

AIM: The aim of this study was to evaluate the sperm abnormalities in young infertile patients with hepatitis B (HBV) or C (HCV) virus infection and to evaluate the additional negative influence of varicocele on sperm parameters in these patients. METHODS: Part I. Forty-two infertile patients in Child-Pugh classification A with HBV (n=23) or HCV (n=19) infection, underwent sperm analysis and quantitative detection of HBV-DNA or HCV-RNA in blood serum. Sperm parameters were compared to those of a group of 30 patients with primary infertility due to causes different from liver diseases and/or varicocele). Part II. Twenty-one infertile patients with varicocele associated to HBV (n=11) or HCV (n=10) infection were also enrolled and underwent semen analysis: a group of 39 patients without liver disease, but with varicocele alone served as matched-control group. RESULTS: Part I. HBV patients (with a median HBV-DNA load of 6x10(5) copies/mL, range 1x10(5)-10x10(6)) showed median sperm parameters (sperm density, total number, forward motility and morphology, viability) significantly worse than those found in patients with HCV (with a median HCV-RNA load of 2.3x10(6) copies/mL, range (2x10(5)-12x10(6)). Sperm parameters showed no significant correlation with the duration of infertility neither with the duration of viral infection. Sperm morphology only, exhibited a trend (P=0.06) of negative correlationship (r=-0.59) with the viral HBV-DNA load, whereas the other sperm parameters studied showed no correlation with the viral load. Part II. The group of infertile patients with HBV and varicocele showed median values of all sperm parameter evaluated significantly worse than those found in infertile patients with varicocele alone, or with HCV infection plus varicocele. CONCLUSIONS: Patients with HBV infection show worse sperm parameters compared with HCV patients. The additional presence of varicocele further impairs sperm output in HBV patients.

Thymostimulin in the treatment of hepatitis B surface antigen-positive chronic active hepatitis. Controlled clinical trial--two years follow-up.

In this paper results obtained with thymostimulin (TP-1 Serono) in patients with hepatitis B surface antigen (HBsAg)-positive chronic active hepatitis after 2 years follow-up are reported. The favourable trend observed in a previous trial was confirmed after a longer observation period, most patients showing a significant amelioration of clinical, biochemical and histological parameters, with respect to control group. Hepatitis B virus (HBV) serology, too, showed a significantly higher rate of seroconversion and antigen disappearance in treated patients. Finally, hospitalization period of the latter was significantly lower. These results, though obtained in a small population of patients, seem to indicate a role for thymic hormone therapy in the management of chronic active hepatitis.

Effectiveness of thymostimulin treatment in hepatitis B surface antigen-positive chronic active liver disease. Results of a randomized clinical trial.

The results of this controlled trial with thymostimulin (TP-1 Serono) on hepatitis B surface antigen (HBsAg)-positive chronic active liver disease (CALD), involving 34 consecutive patients chosen by predefined criteria and randomly allocated to control and treatment groups, show that this thymic hormone may significantly improve the clinical, biochemical, serological and immunological parameters of this disease, and ameliorate the quality of the patients' life. The treatment schedule was adjusted according to the immunological response. Our study population was too small to enable any conclusions to be drawn: further studies are therefore required to establish the exact role of thymostimulin in the treatment of HBsAg-positive CALD.