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Hepatitis E virus (HEV) RNA has been recently discovered in semen samples of Chinese infertile man with a remarkably high rate of 28.1% (52/185, table 1).1 All HEV isolates belong to HEV genotype 4 (HEV4), which is the dominant strain prevalent in China. This intriguing discovery has aroused our attention. In a recent response to the work done by Huang et al, researchers in Germany tested 87 semen samples collected from infertile men, but the HEV RNA positive rate is 0% (table 1).2 Germany is prevalent with HEV3, so the authors suggested that HEV genotype-specific or variant-specific pathophysiology may explain the contrary results. However, the two studies both have limitations to reach a more accurate conclusion. The size of patients included in both studies is relatively small, and …
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