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High prevalence of hepatitis E virus in semen of infertile male and causes testis damage
  1. Fen Huang1,
  2. Feiyan Long1,
  3. Wenhai Yu2,
  4. Jianwen Situ1,
  5. Lijie Fu3,
  6. Zhanlong He2,
  7. Hao Dong3,
  8. Chenchen Yang1,
  9. Yunlong Li1,
  10. Fan Yang1,
  11. Daqiao Wei1
  1. 1 Medical School, Kunming University of Science and Technology, Kunming, China
  2. 2 Laboratory Animal Center, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
  3. 3 Department of Urology Surgery, Kunming Medical University First Affiliated Hospital, Kunming, China
  1. Correspondence to Dr Fen Huang, Medical School, Kunming University of Science and Technology, Kunming, China; huangfen6789{at}163.com

https://doi.org/10.1136/gutjnl-2017-314884

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    We read with interest the paper by Todt et al 1 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

    [SP1.pdf]
    Figure 1

    (A) Positive rate of Hepatitis E virus (HEV) RNA in the semen of …

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    Footnotes

    • FH, FL, WY, JS and LF contributed equally.

    • Contributors FH conceived and supervised the study. JS and FY performed all the HEV detection experiments, analyzed data and wrote a draft of the paper. WY and ZH performed rhesus macaque inoculation and collected tissues. LF and HD collected these clinical samples and performed semen and hormone analysis. JS, CY, YL, FY and DW performed histopathology and immunohistochemistry experiments.

    • Funding This study was supported by National Natural Science Foundation of China (31360619, 81660338 and 31572525), Natural Science Foundation of Yunnan Province (2011FZ068, 2013FB032 and 2017FA036), Fundamental Research Funds for the Central Universities (20162X310179-3) and PUMC youth fund (2017310038).

    • Competing interests None declared.

    • Ethics approval Kunming University of Science and Technology.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Author note We added DW’s contribution.