***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: OBJECTIVES : Although sexual dysfunction has been reported in patients with hepatitis C virus ( HCV ) infection , little is known about this association . The aims of this study were to determine the prevalence of sexual dysfunction among men with chronic HCV infection and to evaluate the impact of sexual dysfunction on health-related quality of life ( HRQOL ) . METHODS : We prospect ively enrolled 112 HCV positive men and 239 HCV negative controls , and all patients completed vali date d question naires to assess sexual function ( Brief Male Sexual Function Inventory [ BMSFI ] ) , depression ( Beck Depression Inventory )  , and HRQOL ( Medical Outcomes Study Short Form-36 )  . The BMSFI assessed sexual drive , erection , ejaculation , sexual problem assessment , and overall sexual satisfaction . RESULTS : HCV positive men had significantly more sexual dysfunction than control subjects across all five domains of the BMFSI . In addition , HCV-infected men were significantly more likely than controls to not be sexually satisfied ( 53.6 % vs 28.9 % , p < 0.001 ) and this remained statistically significant after adjusting for age , race , and other potential confounding variables ( OR = 3.36 ; 95 % CI , 1.59–7.13 ) . In the 241 individuals without depression , HCV positive men were significantly more likely to not be sexually satisfied as compared with control subjects ( 47.5 % vs 11.0 % , p < 0.001 ) . HCV-infected men who were not sexually satisfied scored significantly worse in six of eight domains of HRQOL as compared with HCV-infected men who were sexually satisfied . CONCLUSIONS : Sexual dysfunction is highly prevalent in men with chronic HCV infection , is independent of depression , and is associated with a marked reduction in HRQOL The effects of interferon-alpha ( IFN-alpha ) , given at a dosage of 6 MU thrice weekly for 12 months , on gonadal function were investigated in 18 males affected by chronic hepatitis C. Periodically , all patients were clinical ly monitored and question ed about sexual function . Gonadotropin and serum and rogen concentrations ( follicle-stimulating hormone , luteinizing hormone , total testosterone , free testosterone , and rostenedione , dehydroepi and rosterone , dehydroepi and rosterone sulfate , and sex hormone binding globulin ) were tested every 3 months . Ten of 18 patients ( 55 % ) responded to IFN-alpha therapy . Serum total testosterone and sex hormone binding globulin values decreased slightly at the third month of treatment , then returned to baseline values . Serum free testosterone and other sex hormones remained essentially unchanged during IFN-alpha therapy . Four patients ( 22.2 % ) complained of sexual dysfunction ( impaired libido , erectile failure , and impaired ejaculation ) , which was unrelated to any significant hormonal change and resolved after IFN therapy was stopped . Serum sex hormones values did not differ between responders and nonresponders to IFN-alpha . This study indicates that 12 months treatment with 6 MU of IFN-alpha thrice weekly does not significantly affect gonadal function in men with chronic hepatitis C. The sexual dysfunction observed could be ascribed to such other side effects of IFN as asthenia , fatigue , or anxiety , or it could have a psychologic basis OBJECTIVE Recombinant human interferon alpha ( rhIFN-alpha ) is used therapeutically in malignant disorders and chronic hepatitis . The present study was assessed to study the effects of rhIFN-alpha on the hypothalamic-pituitary-testicular ( HPT ) axis . DESIGN AND METHODS We performed a saline-controlled cross-over study in six healthy men , sequentially measuring the serum concentrations of gonadotropins , testosterone , the free and rogen index ( FAI ) and sex hormone-binding globulin ( SHBG ) after a bolus subcutaneous injection of rhIFN-alpha . RESULTS rhIFN-alpha induced a sustained decrease of both testosterone ( from 19.5+/-1.88 to a nadir of 5.49+/-0.51nmol/l at the end of the study ) and FAI ( from 98.7+/-14.7 to a nadir of 32 . 1+/-5.3 at the end of the study ) , whereas concentrations of LH , FSH and SHBG were not different between the two studies . CONCLUSIONS Our results suggest that rhIFN-alpha affects the HPT axis at the testicular level , either directly or indirectly , and changes feedback relationships between the pituitary and the testis INTRODUCTION In men , erectile dysfunction ( ED ) is an important issue . Data concerning ED in men with end-stage liver disease ( ESLD ) is limited , and the risk factors for ED in this population are still unknown . AIMS To determine the prevalence , timescale , and risk factors for ED in ESLD patients c and i date s to liver transplantation . METHODS Patients c and i date s for a liver transplantation were asked to participate in a mailed survey about sexual function .  Among the 123 eligible men , 98 ( 84 % ) agreed to complete the question naire . MAIN OUTCOME MEASURES The quality of erection was evaluated using the five-item International Index of Erectile Function ( IIEF-5 ) score , and satisfaction for sexuality , using the patient-baseline Treatment-Satisfaction Scale ( TSS ) score . Other questions also focused on patient perception of changes over time . RESULTS On the overall population , 28 patients ( 29 % ) were nonsexually active . Among the 70 patients who were sexually active , 52 patients ( 74 % ) had ED . Regarding the development of ED , 50 % of the patients perceived that a deterioration of erectile function occurred within the six previous months . The absence of sexual activity was more frequent in hepatitis B or C patients ( P = 0.02 ) . The risk factors for ED were alcohol intake ( P = 0.03 ) , tobacco use ( P = 0.03 ) , and cardiovascular disease ( P = 0.004 ) . The significant risk factors for having a low TSS score were having viral hepatitis ( P = 0.01 ) , and cardiovascular disease ( P = 0.01 ) . CONCLUSION Population of men with ESLD who are c and i date s for a liver transplantation is characterized by a high frequency of lack of sexual activity , and by a high prevalence of ED and should be targeted by interventions to improve sexual functioning . These preliminary data need further validation in prospect i ve trial using more comprehensive question naires BACKGROUND & AIMS Compared with Caucasian Americans ( CA ) , African Americans ( AA ) with chronic hepatitis C are less likely to respond to interferon-based antiviral therapy . METHODS In a multicenter treatment trial , 196 AA and 205 CA treatment-naive patients with hepatitis C virus ( HCV ) genotype 1 infection were treated with peginterferon alfa-2a ( 180 microg/wk ) and ribavirin ( 1000 - 1200 mg/day ) for up to 48 weeks . The primary end point was sustained virologic response ( SVR ) . RESULTS Baseline features were similar among AA and CA , including HCV-RNA levels and histologic severity , but AA had higher body weights , a higher prevalence of diabetes and hypertension , and lower alanine transaminase levels ( P < .001 for all ) . The SVR rate was 28 % in AA and 52 % in CA ( P < .0001 ) . Racial differences in viral responses were evident as early as treatment week 4 . Breakthrough viremia was more frequent among AA than CA ( 13 % vs 6 % , P = .05 ) ; relapse rates were comparable ( 32 % vs 25 % , P = .30 ) . Proportions of patients with serious adverse events and dose modifications and discontinuations were similar among AA and CA . In multiple regression analyses , CA had a higher SVR rate than AA ( relative risk , 1.96 ; 95 % confidence interval , 1.48 - 2.60 ; P < .0001 ) . Other factors independently associated with higher SVR included female sex , lower baseline HCV-RNA level , less hepatic fibrosis , and more peginterferon taken . CONCLUSIONS AA with chronic hepatitis C genotype 1 have lower rates of virologic response to peginterferon and ribavirin than CA . These differences are not explained by disease characteristics , baseline viral levels , or amount of medication taken OBJECTIVE OF THE STUDY To report on the results of two projects on chronic hepatitis B in Western Balkans lead by Ioannina , Northwest Greece and Tirana , Albania . METHODS In two prospect i ve projects , HEPAGA I and HEPAGA II which lasted 4 years . In HEPAGA I , serum sample s from 410 Albanians were tested for HBV . In HEPAGA II , health care consumption was recorded in hospitalized patients with chronic hepatitis B. RESULTS HEPAGA I showed that 11.89 % of the Albanians was HBsAg(+ ) and only 21.19 % had HBV immunoprotection .  HEPAGA  II study included 101 patients . There was a significant difference in hospitalization costs per patient between centers . The Greek patients were significantly older ( p=0.027 ) and there was a significant correlation between age > 50 years and hospitalization costs ( p=0.035 ) . In Greece , hospitalization costs , number of patients admitted and number of hospitalization days per patient were in a remarkable position compared to other causes of hospitalization . CONCLUSIONS The HEPAGA I study showed a decrease in the prevalence of chronic HBV infection in Albania compared to that of the previous decade . The HEPAGA II study demonstrated that health care consumption due to HBV infection is still an important determinant of the overall health consumption in Western Balkans The prevalence and course of sexual dysfunction was evaluated in 221 alcoholic cirrhotic men participating in a double-blind , placebo-controlled study on the effect of oral testosterone treatment on liver disease . At entry , 67 % ( 95 % confidence limits , 61%-74 % ) complained of sexual dysfunction .  Sexual dysfunction was significantly ( p less than 0.05 ) associated with lower serum concentrations of testosterone , non-protein-bound testosterone , and non-sex hormone-binding globulin-bound testosterone . The significant associations between sexual dysfunction and non-protein-bound and non-sex hormone-binding globulin-bound testosterone concentrations disappeared , however , when age , ethanol consumption , and severity of liver disease were included as covariates in the analysis . During follow-up ( median 30 mo , range 1 - 48 mo ) sexual dysfunction improved significantly ( p less than 0.05 ) at 6 , 12 , and 24 mo . Furthermore , the reported libido and erectile and ejaculatory function improved significantly at the end of the follow-up period ( p less than 0.01 ) . However , the testosterone-treated patients did not differ significantly from the placebo-treated patients regarding any of the changes in sexual function . In conclusion , oral testosterone treatment does not significantly influence the type or course of sexual dysfunction in alcoholic cirrhotic men . However , sexual function improved after reduction of ethanol consumption in these patients Decrease of libido and erectile dysfunction are reported by male patients during antiviral therapy of chronic hepatitis C , but therapy-associated underlying factors for sexual dysfunction are not well defined . To assess putative contributions of interferon-induced sex hormone changes to sexual dysfunction , we prospect ively investigated changes in free testosterone , total testosterone , dehydroepi and rosterone sulfate , prolactin , sex hormone-binding globulin , FSH and LH levels and psychometric self- assessment scores in 34 male patients treated with interferon alfa-2b ( 5 MIU three times weekly ) (n=19)+ ribavirin ( n=15 ) for 6 - 12 months .  Depression was measured by the Hospital Anxiety and Depression Scale . Sexual dysfunction was evaluated by the Symptom Checklist 90 Item Revised and a five-point rating scale assessing sexual arousal disorder . Free and total testosterone decreased significantly during antiviral therapy in close correlation with libido/sexual function . Depression scores increased during therapy and were also significantly associated with sexual dysfunction . However , and rogen levels displayed no significant correlation with depression . These results suggest that interferon-induced decrease in sexual function is associated - but not causally related -with both and rogen reduction and increased depressive symptoms . These findings may affect care for male hepatitis C patients during interferon therapy PURPOSE We assessed the change in confidence , relationships and self-esteem , and its correlation with erectile function in men with ED treated with sildenafil citrate  in the first United States based , double-blind , placebo controlled , r and omized trial assessed by the vali date d SEAR . MATERIAL S AND METHODS This 12-week flexible dose ( 25 , 50 or 100 mg ) trial determined change scores from baseline to end of treatment for the 5 SEAR components ( Sexual Relationship domain , Confidence domain , Self-Esteem subscale [ prespecified as the primary end point ] , Overall Relationship subscale and Overall score ) , and their correlations with the IIEF and event log data , as well as correlations between SEAR components and a general efficacy question at the end of treatment . RESULTS Compared with the  place 
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EXPERT OPINION The results of this review have led to the following main observations : i ) there is scarce documentation on the association between CVH and sexual dysfunction ; ii ) hormonal impairment seems to be a major component in the development of erectile dysfunction in CVH ; however , published evidence concerning the contribution of other pathogenetic factors is rare and inconclusive and iii ) available treatment options for CVH potentially contribute to the development of sexual dysfunction in these patients .