الفهرس 
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Abstract
Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. chronic hepatitis C virus infection and historical treatment with Peg-INF and ribavirin increase the risk of erectile dysfunction in men. Direct acting antiviral agents (DAAs) have revolutionized the treatment of hepatitis C virus infection and now sofosbuvir and daclatasvir co-administration represents the preferred therapy, however limited data are available on the side effects resulting from this co-administration. The present study aims to assess the erectile function, serum total testosterone and serum prolactin levels in naïve chronic hepatitis C virus patients before and after the Direct-acting Antiviral Agents (DAAs) regimen (sofosbuvir with daclatasvir). This study was carried out in Assiut University Hospitals, Department of Dermatology, Venereology and Andrology in collaboration with Department of Tropical medicine, during the period from August 2017 to September 2018, on fifty married patients less than 60 years old with regular marital life suffering from naïve chronic hepatitis C virus infection who were attending regularly to Al-Rajhi hospital, Assiut University for receiving the oral direct acting anti-HCV regimen ”sofosbuvir and daclatasvir” for three months. After proper patient selection, the concept of the study was explained to the participants and written informed consents were obtained from patients, then each patient was subjected to:- History taking. General and sexual examination. Evaluation of the erectile function using IIEF-5 questionnaire. Measurement of serum total testosterone and prolactin levels. Assessment of the patients before and after the treatment course revealed the following: We reported 14 out of 50 patients complained from erectile dysfunction (IIEF-5 score ≤ 21) representing 28% of the study population. After the end of the treatment course, the total IIEF-5 score was statistically significantly higher than that of before starting the treatment course. We also found that serum levels of total testosterone and prolactin hormones were statistically significantly lower than their levels before starting the treatment course. There was a statistically significant positive correlation between the total IIEF-5 score and serum levels of total testosterone, while there was a statistically significant negative correlation between the total IIEF-5 score and serum levels of prolactin hormone. from the present results, it could be concluded that: chronic hepatitis C virus infection was associated with impairment of the erectile function, even in the absence of cirrhosis. This might be attributed to the abnormal hormonal profile in chronic HCV patients. chronic hepatitis C virus infection was also associated with elevated serum levels of total testosterone and prolactin hormones which became lower after the treatment course. DAAs (sofosbuvir and daclatasvir) have demonstrated a tolerability and safety as regards the erectile function; furthermore there was significant improvement in the erectile function after the end of the treatment course.