Hepatitis E virus persists in the ejaculate of chronically infected men

Area of Science:

• Virology
• Hepatology
• Reproductive Medicine

Background:

• Hepatitis E virus (HEV) infections are a global health concern.
• HEV can replicate in organs beyond the bloodstream, potentially affecting the male reproductive system.
• Understanding HEV replication sites is crucial for managing chronic infections.

Purpose of the Study:

• To investigate the presence, characteristics, and morphology of HEV in ejaculate.
• To determine if the male reproductive system serves as a niche for HEV persistence.

Main Methods:

• HEV-PCR testing of ejaculate, urine, stool, and blood from infected pigs and humans.
• Genomic sequencing of HEV particles from various bodily compartments.
• Immune-electron microscopy and density gradient measurements to characterize HEV particles.

Main Results:

• HEV-RNA was detected in seminal plasma and semen of chronically infected patients, with higher viral loads than in serum.
• Genomic sequencing revealed distinct HEV strains in ejaculate compared to stool/serum.
• Intact, enveloped HEV particles were identified in ejaculate via electron microscopy.

Conclusions:

• The male reproductive system acts as a reservoir for HEV persistence in chronic infections.
• Distinct genetic HEV variants may originate from the male reproductive system, separate from liver-derived strains.
• HEV particles in ejaculate are morphologically similar to those in serum.