The Effect of Hepatitis B Virus Infection on Semen Quality of Infertile Men: A Systematic Review and Meta-Analysis of Observational Studies.

Semen quality is considered as an alternative measure for men's fertility. Several studies have examined the association between the hepatitis B virus (HBV) infection and semen quality, but the findings have been inconclusive. This study investigated the effects of HBV on semen quality. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020, as well as Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. In this study, international electronic databases including PubMed (National Library of Medicine), Web of Science, Scopus and Cochrane Library and also Persian databases including Scientific Information Database (SID) and Magiran were searched without a time limit until June 2023. All cohort and case-control studies examining the effects of HBV infection on the semen parameters of infertile men were included in the study. Animal studies, letters to the editor and case reports were excluded. The Newcastle-Ottawa scale was used to evaluate the quality of the included articles. Data analysis was done with Stata software. Of the 913 studies, 13 observational studies comprised a total of 10156 patients were included in this review, nine of which were included in the meta-analysis. The results showed that HBV infection has a negative effect on semen volume (95% confidence interval (CI): [-0.33, -0.09], P<0.001), sperm concentration (95% CI: [-8.53, -2.66], Pv<0.001), sperm motility (95% CI: [-10.06, -3.39], P<0.001), sperm normal morphology (95% CI: [-6.42, -1.06], P<0.001) and sperm viability (95% CI: [-11.64, -0.31], P<0.001). These results suggest that the HBV infection has a negative effect on the semen quality in infertile men. Nonetheless, further research with more robust design is recommended.