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

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.