背景:一些研究表明,乙型肝炎病毒(HBV)感染与精液质量呈负相关,但是结论不一致。我们研究的目的是系统地评估HBV感染与精液参数之间的关联。
方法:我们在电子数据库中搜索了1980年1月至2023年8月发表的研究。分析中包括11项研究。主要结果是精液体积,精子浓度,精子形态学,精子运动性和精子进行性运动性。我们还对中国和其他国家进行了分组分析。
结果:与HBV阴性男性的精液质量相比,HBV感染与精液体积呈负相关(MD:-0.20mL,95CI:-0.32至-0.09,P=0.0004),精子浓度(MD:-4.46×106/mL,95CI:-7.09至-1.84,P=0.0009),精子形态(MD:-2.49%,95CI:-4.35至-0.64,P=0.008),精子活力(MD:-6.85%,95CI:-11.53至-2.18,P=0.004),和精子进行性运动性(MD:-6.63%,95CI:-10.24至-3.02,P=0.0003)。然而,HBV感染与精子总数无明显相关性(MD:-31.50×106,95CI:-74.11至11.10,P=0.15)。HBV与精液质量之间的关联在亚组之间不一致。
结论:HBV感染与精子浓度呈负相关,运动性,形态学,和精液量。然而,HBV与精子总数之间的关联尚不清楚。这项荟萃分析表明,我们应该注意HBV对精子质量的不利影响,一些研究报告了相关机制。但是由于某些精液参数研究之间的显着异质性,在引入临床管理建议之前,还需要进一步的大型和精心设计的研究。
BACKGROUND: Some studies have suggested that hepatitis B virus (HBV) infection had a negative association with semen quality, but the conclusions have been inconsistent. The purpose of our study was to systematically assess the association between HBV infection and semen parameters.
METHODS: We searched electronic databases for studies published from January 1980 to August 2023. Eleven studies were included in the analysis. Primary outcomes were semen volume, sperm concentration, sperm morphology, sperm motility and sperm progressive motility. We also conducted a subgroup analysis between China and other countries.
RESULTS: Compared with the semen quality of HBV-negative men, HBV infection had a negative association with semen volume (MD: -0.20 mL, 95%CI: -0.32 to - 0.09, P = 0.0004), sperm concentration (MD: -4.46 × 106/mL, 95%CI: -7.09 to - 1.84, P = 0.0009), sperm morphology (MD: -2.49%, 95%CI: -4.35 to - 0.64, P = 0.008), sperm motility (MD: -6.85%, 95%CI: -11.53 to - 2.18, P = 0.004), and sperm progressive motility (MD: -6.63%, 95%CI: -10.24 to - 3.02, P = 0.0003). However, HBV infection had no significant association with total sperm count (MD: -31.50 × 106, 95%CI: -74.11 to 11.10, P = 0.15). The association between HBV and semen quality were inconsistent between the subgroups.
CONCLUSIONS: HBV infection had a negative association with sperm concentration, motility, morphology, and semen volume. However, The association between HBV and total sperm count remain unclear. This metaanalysis suggests that we should pay attention to the adverse effect of HBV on sperm quality, and several studies have reported the relevant mechanisms. But due to the significant heterogeneity among studies on some semen parameters, further large and well-designed researches are needed before introducing clinical management recommendations.