Co-Infection With Hepatitis E Virus and SARS-CoV-2 in a Lymphoma Patient

Yacine Boucetta; Céline Boschi; Erika Peroni; Rodolphe Jean; Erwan Bories; Patrick Borentain; Julien Andreani; Philippe Colson

doi:10.1002/jmv.70706

Co-Infection With Hepatitis E Virus and SARS-CoV-2 in a Lymphoma Patient

J Med Virol. 2025 Nov;97(11):e70706. doi: 10.1002/jmv.70706.

Authors

Yacine Boucetta¹, Céline Boschi^{1

2

3}, Erika Peroni¹, Rodolphe Jean⁴, Erwan Bories⁵, Patrick Borentain⁶, Julien Andreani^{1

2

3}, Philippe Colson^{1

2

3}

Affiliations

¹ IHU Méditerranée Infection, Marseille, France.
² Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
³ Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.
⁴ Assistance Publique-Hôpitaux de Marseille (AP-HM), Internal Medicine and Clinical Immunology Department, CHU Conception, Marseille, France.
⁵ Private medical practice in hepatogastroenterology, Aix-en-Provence, France.
⁶ Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Timone, service d'Hépatologie, Marseille, France.

Abstract

Hepatitis E virus (HEV) and SARS-CoV-2 are both ubiquitous worldwide. We report here a rare case of HEV and SARS-CoV-2 coinfection. HEV and SARS-CoV-2 diagnoses were carried out by qPCR. Virus genotyping was performed by analyzing partial or near full-length genomes obtained by next-generation sequencing from plasma or nasopharyngeal specimens, respectively. The case was a lymphoma patient admitted to hospital for oxygen-requiring qPCR-documented Covid-19. SARS-CoV-2 was a Delta variant. Reevaluation of a liver cytolysis documented 1 year earlier revealed concurrent chronic hepatitis E at cirrhosis stage. HEV genotype was 3c. Ribavirin was administered, but to date only temporarily led to HEV RNA undetectability in plasma when combined with immunosuppressive therapy interruption. This case and the three previous cases of coinfection with HEV and SARS-CoV-2 point out the possible deleterious effect of SARS-CoV-2 on the liver and the increased risk of such concurrent infections in immunocompromized patients.

Keywords: SARS‐CoV‐2; coinfection; hepatitis; hepatitis E virus.

Publication types

Case Reports

MeSH terms

Antiviral Agents / therapeutic use
COVID-19* / complications
COVID-19* / diagnosis
COVID-19* / virology
Coinfection* / diagnosis
Coinfection* / virology
Hepatitis E virus / genetics
Hepatitis E virus / isolation & purification
Hepatitis E* / complications
Hepatitis E* / diagnosis
Hepatitis E* / drug therapy
Hepatitis E* / virology
Humans
Immunocompromised Host
Lymphoma* / complications
Lymphoma* / virology
RNA, Viral / blood
Ribavirin / therapeutic use
SARS-CoV-2* / genetics
SARS-CoV-2* / isolation & purification

Substances

Antiviral Agents
Ribavirin
RNA, Viral

Grants and funding

This workstudy was supported by the French Government under the "Investments for the Future" program managed by the National Agency for Research (ANR), Méditerranée-Infection 10-IAHU-03; and by the French Ministry of Higher Education, Research and Innovation (Ministère de l'Enseignement supérieur, de la Recherche et de l'Innovation) and the French Ministry of Solidarity and Health (Ministère des Solidarités et de la Santé).