Hepatitis E viruses also get into the testicles – healing practice

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Hepatitis E viruses detectable in the ejaculate of chronically infected people

In most cases, hepatitis E disease is not a particular threat and will heal on its own. But people with a weakened immune system can develop chronic hepatitis E and cause severe liver damage. In a recent study it has now become clear that HEV can also be detected in the ejaculate in chronically infected men, which may be related to recurring reactivations of the virus.

Infections with the hepatitis E virus (HEV) are also relatively widespread in Germany and around every sixth adult in this country carries according to the Robert Koch Institute (RKI) corresponding antibodies in itself. As a rule, the infections are harmless, but in people with a weakened immune system they can also take a chronic course and lead to liver cirrhosis after just a few years. In men, the testicles could provide a retreat for the viruses, which enables reactivation after supposedly successful therapy.

HEV in Ejaculate

The research team led by Dr. Sven Pischke from the German Center for Infection Research (DZIF), Dr. Thomas Horvatits from the University Medical Center Hamburg-Eppendorf (UKE) and Prof. Dr. Eike Steinmann from the Ruhr University Bochum (RUB) and Prof. Reimar Johne from the Federal Office for Risk Assessment (BfR) made an exciting discovery in his current research: HEV can still be detected in the ejaculate even after drug therapy. The corresponding study results were published in the specialist magazine “Journal of Hepatology“.

In their study, the researchers examined “using electron microscopy, polymerase chain reaction, density centrifugation and genome sequencing, the blood, urine, stool and ejaculate from a total of nine hepatitis E patients: including three immunosuppressed patients with chronic viral hepatitis E and six other test subjects with an intact immune system and an acute hepatitis E infection, ”explains the DZIF in one Press release to the study results.

Reactivation of the virus

In the studies, two of the three chronically infected patients found a significantly higher viral load in the ejaculate than in the blood, and HEV could no longer be detected in the blood during therapy with the antiviral drug ribavirin, but it was in the ejaculate, the DZIF reports. After the treatment, the viral load in serum, ejaculate and stool rose rapidly again, which should be assessed as a possible indication of a reactivation of the HEV infection affecting the whole body.

The place of retreat in the male reproductive system could be responsible for the fact that viral hepatitis E is reactivated in men with chronic hepatitis E despite antiviral therapy and initially falling virus concentration in the blood. In the six immunocompetent patients with acute hepatitis E, however, no HEV could be detected in the ejaculate.

Male reproductive system as a place of retreat

“Evolution has shown that the blood-testicular barrier is impermeable to cells of the immune system and pollutants”, but “if patients with a weakened immune system become infected with hepatitis E, the virus can cross the barrier unhindered and remain in the male gonads” , explains Dr. Pischke. In this case, the “blood-testicular barrier is a disadvantage for the patient, because immune cells cannot penetrate the testicles to fight the pathogens there.”

Can Hepatitis E Infection Be Sexually Transmitted?

According to the RKI, infection with HEV usually occurs in Germany through contaminated game or pork. Infections from contaminated water are also mentioned. However, human-to-human infections are rated as extremely unlikely in Germany. In view of the current study results, however, the question arises whether chronically infected hepatitis E patients are infectious for their sexual partners through the ejaculate. According to the DZIF, this is now to be investigated in further studies. (fp)