Hepatitis E virus replication is maintained in proliferative cells within the intestinal crypt

Sci Adv. 2026 Apr 3;12(14):eaeb2333. doi: 10.1126/sciadv.aeb2333. Epub 2026 Apr 1.

Abstract

The hepatitis E virus (HEV) is a leading cause of acute hepatitis worldwide. Although most infections are self-limiting, zoonotic genotypes can persist in immunocompromised individuals. Transmitted via the fecal-oral route, HEV has been suggested to directly infect the intestinal epithelium, a tissue with high regenerative capacity. Here, we demonstrate that HEV predominantly infects proliferative transit-amplifying and intestinal stem cells within the crypts of human pluripotent stem cell-derived intestinal organoids (hIOs). Supporting this, we detected HEV RNA in the intestinal crypts of an HEV-infected patient. We further found that HEV infection spreads through cell division and is maintained in hIOs for more than 40 days, contrasting with acute hepatitis A virus, whose infections are rapidly cleared from hIOs. Given the self-renewal ability and metabolic constraints of proliferative intestinal progenitor cells, our findings suggest that intestinal crypts could serve as reservoirs for chronic HEV infection and highlight the intestinal crypt as a primary target for viral infection in the gastrointestinal tract.

MeSH terms

  • Cell Proliferation
  • Hepatitis E virus* / genetics
  • Hepatitis E virus* / physiology
  • Hepatitis E* / pathology
  • Hepatitis E* / virology
  • Humans
  • Intestinal Mucosa* / virology
  • Organoids / virology
  • RNA, Viral / genetics
  • Stem Cells / virology
  • Virus Replication*

Substances

  • RNA, Viral