Department of Obstetrics and Gynecology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Invitra - Assisted Reproductive Technologies LTD, Supera Innovation and Technology Park, Ribeirão Preto, São Paulo, 14056-680, Brazil.
J Assist Reprod Genet. 2019 Jul;36(7):1339-1349. doi: 10.1007/s10815-019-01493-y. Epub 2019 May 30.
Zika virus (ZIKV) is mainly transmitted through Aedes mosquito bites, but sexual and post-transfusion transmissions have been reported. During acute infection, ZIKV is detectable in most organs and body fluids including human semen. Although it is not currently epidemic, there is a concern that the virus can still reemerge since the male genital tract might harbor persistent reservoirs that could facilitate viral transmission over extended periods, raising concerns among public health and assisted reproductive technologies (ART) experts and professionals. So far, the consensus is that ZIKV infection in the testes or epididymis might affect sperm development and, consequently, male fertility. Still, diagnostic tests have not yet been adapted to resource-restricted countries. This manuscript provides an updated overview of the cellular and molecular mechanisms of ZIKV infection and reviews data on ZIKV persistence in semen and associated risks to the male reproductive system described in human and animal models studies. We provide an updated summary of the impact of the recent ZIKV outbreak on human-ART, weighing on current recommendations and diagnostic approaches, both available and prospective, with special emphasis on mass spectrometry-based biomarker discovery. In the light of the identified gaps in our accumulated knowledge on the subject, we highlight the importance for couples seeking ART to follow the constantly revised guidelines and the need of specific ZIKV diagnosis tools for semen screening to contain ZIKV virus spread and make ART safer.
Zika 病毒（ZIKV）主要通过埃及伊蚊叮咬传播，但已报告存在性传播和输血后传播。在急性感染期间，ZIKV 可在包括人类精液在内的大多数器官和体液中检测到。尽管目前该病并非流行，但人们担心病毒仍可能再次出现，因为男性生殖道可能存在持续的病毒储存库，这可能会导致病毒在较长时间内传播，引起公共卫生和辅助生殖技术（ART）专家和专业人员的担忧。到目前为止，共识认为睾丸或附睾中的 ZIKV 感染可能会影响精子的发育，从而影响男性生育能力。尽管如此，诊断检测尚未在资源有限的国家中得到应用。本文提供了 Zika 病毒感染的细胞和分子机制的最新概述，并回顾了人类和动物模型研究中描述的 Zika 病毒在精液中持续存在及其对男性生殖系统相关风险的数据。我们对最近的 Zika 病毒爆发对人类-ART 的影响进行了更新总结，权衡了当前的建议和诊断方法，包括现有的和前瞻性的方法，特别强调了基于质谱的生物标志物发现。鉴于我们在该主题的累积知识方面存在差距，我们强调了寻求 ART 的夫妇遵循不断修订的指南的重要性，以及需要针对精液筛查的特定 Zika 病毒诊断工具来控制 Zika 病毒的传播并使 ART 更安全的重要性。
