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 betweenthe hepatitis B virus (HBV) infection and semen quality, but the findings have been inconclusive. This study investigatedthe effects of HBV on semen quality. This systematic review and meta-analysis was conducted according to the Preferred ReportingItems for Systematic reviews and Meta-Analyses (PRISMA) 2020, as well as Meta-analysis Of Observational Studiesin Epidemiology (MOOSE) guideline. In this study, international electronic databases including PubMed (National Library ofMedicine), 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 theeffects of HBV infection on the semen parameters of infertile men were included in the study. Animal studies, letters to the editorand case reports were excluded. The Newcastle-Ottawa scale was used to evaluate the quality of the included articles. Dataanalysis was done with Stata software. Of the 913 studies, 13 observational studies comprised a total of 10156 patients wereincluded in this review, nine of which were included in the meta-analysis. The results showed that HBV infection has a negativeeffect on semen volume (95% confidence interval (CI): [-0.33, -0.09], P 0.001), sperm concentration (95% CI: [-8.53, -2.66],P 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) andsperm viability (95% CI: [-11.64, -0.31], P 0.001). These results suggest that the HBV infection has a negative effect on thesemen quality in infertile men. Nonetheless, further research with more robust design is recommended.