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We read with interest the paper by Todt et al1 concerning the mutagenesis of Hepatitis E virus (HEV) caused by ribavirin treatment. HEV is a major cause of acute hepatitis worldwide and lacks a specific treatment.1 2 It replicates in many extrahepatic sites (spleen, kidney, brain and muscle3–5), but whether the testis is included is unknown. Active HEV has been detected in body fluids (blood,2 urine4 and milk6), but no report exists for semen.
Thus, HEV prevalence in the semen of infertile males (n=185) sexually abstinent for at least 2 days was investigated by reverse transcriptase-PCR. Ethical approval was obtained from the Institutional Ethics Committee. Unexpectedly, 28.11% (52/185) of the males were HEV RNA positive (HEV RNA+; detectable HEV ORF1 and ORF2 were considered as HEV RNA+, figure 1A) with comparable viral titers to that from urine (see figure S1 in the online supplementary file 1). The prevalence of HEV in semen was higher in infertile males than in serum of pregnant women (1.82%) or the general population (0.58%) in the same city.
Supplementary file 1
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