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Hepatitis E Virus Persists In the Ejaculate of Chronically Infected Men, Study Reveals

A recent study has revealed that hepatitis E virus or HEV appears to persist in the ejaculate of chronically infected men who are immunosuppressed.

Photo: Male Reproductive System | InStyleHealth

Research included 9 HEV patients, of whom three were chronically infected with HEV genotype 3, while the remaining 6 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 3 patients with chronic infections repeatedly tested HEV-positive in their ejaculate. A quantitative analysis revealed RNA levels that were >2 logs greater than that in serum samples.

Particularly, while ribavirin treatment eliminated HEV viraemia in both patients, their ejaculate samples nevertheless continued to test positive for HEV RNA. In one patient, RNA positivity outlasted viraemia for more than 9 months.

The viral load increased dramatically, over time, in serum, ejaculate, and stool samples drawn from the 3 chronically infected participants. On the other hand, ejaculate samples from six immunocompetent patients did not test positive for HEV RNA, and neither did they show an increase in viral load over time.

Researchers aid that the virus seems to avoid being eliminated by the human immune response by utilizing the immunological niche of the male reproductive system. Researchers also noted that 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 infectivity of HEV virions derived from different bodily fluids is required.


Source: J Hepatol 2021;75:55-63

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