The hepatitis E virus (HEV) seems to persist in the ejaculate of chronically infected men who are immunosuppressed, a recent study has found.

The study included nine HEV patients, of whom three were chronically infected with HEV genotype 3, while the remaining six were immunocompetent and only had acute infections. Stool, urine, ejaculate, and blood samples were collected from all participants and subjected to polymerase chain reaction to characterize virus morphology and genomics.

Two of the three patients with chronic infections repeatedly tested HEV-positive in their ejaculate. Quantitative analysis revealed RNA levels that were >2 logs greater than that in serum samples.

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What is Hepatitis E

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV). The virus has at least 4 different types: genotypes 1, 2, 3 and 4. Genotypes 1 and 2 have been found only in humans. Genotypes 3 and 4 circulate in several animals (including pigs, wild boars, and deer) without causing any disease, and occasionally infect humans.

The virus is shed in the stools of infected persons and enters the human body through the intestine. It is transmitted mainly through contaminated drinking water. Usually the infection is self-limiting and resolves within 2–6 weeks. Occasionally a serious disease, known as fulminant hepatitis (acute liver failure) develops, and a proportion of people with this disease can die.

“Future studies are clearly needed to further elucidate and fully understand the impact of HEV replication in the male reproductive system. In addition, further study of the infectivity of HEV virions derived from different bodily fluids is required,” they noted.

J Hepatol 2021;75:55-63