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To the Editor: Hepatitis E virus is an emerging infection in developed countries, with many clinical manifestations.¹ We describe a 48-year-old bisexual white male who was infected with human immunodeficiency virus type 1 (HIV-1) and who had elevated liver enzymes and infection with hepatitis E virus for at least 24 months. He had received a diagnosis of HIV infection in 2001 and was treated for tuberculosis in 2003. He had a 20-year history of excessive alcohol consumption (30 to 40 units [8 g of pure alcohol] per week) but reported never having injected drugs or received blood products. In January . . .