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No link between male infertility and HEV genotype 3 infection
  1. Thomas Horvatits1,2,
  2. Domenica Varwig-Janssen3,
  3. Julian Schulze zur Wiesch1,2,
  4. Rabea Lübke1,
  5. Svenja Reucher4,
  6. Sebastian Frerk1,
  7. Marylyn M Addo1,2,
  8. Stefan W Schneider3,
  9. Ansgar W Lohse1,2,
  10. Marc Luetgehetmann2,4,
  11. Sven Pischke1,2
  1. 1 Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  2. 2 German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
  3. 3 Department of Dermatology and Venerology, University Medical Centre Hamburg-Eppendorf, Hamburg, Hamburg, Germany
  4. 4 Institute of Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  1. Correspondence to Dr Thomas Horvatits, Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg 20251, Germany; t.horvatits{at}

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With great interest we read the article ‘High prevalence of hepatitis E virus in semen of infertile male and causes testis damage’ recently published by Huang et al in GUT.1 The authors report a strikingly high rate of 28% of hepatitis E virus (HEV) RNA PCR positivity (all of them genotype 4 hour) in semen from infertile men from the Chinese Kunming region (n=185) and they could demonstrate HEV antigens in the testes and HEV-RNA in semen of acutely infected macaques.1 This finding is without precedence and has never been reported. Pathophysiologically, the high rate of HEV detection in semen of infertile men could only be explained by HEV persistence beyond the blood-testis barrier.

Duration of PCR positivity in semen has not been assessed by the authors neither in the infertile man nor in the macaques. Thus, it remains unclear …

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