Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France; Department of Pathology, Sheba Medical Center, Tel HaShomer, Israel.
Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France.
Reprod Biomed Online. 2019 Oct;39(4):624-632. doi: 10.1016/j.rbmo.2019.05.013. Epub 2019 May 24.
To determine whether there is a risk of localized Zika virus (ZIKV) infection in the upper genital tract, specifically the oocytes, follicular fluids and endometrium, in exposed and/or recently infected reproductive-age women. ZIKV is an Aedes mosquito-borne Flavivirus that can lead to birth defects and to developmental anomalies when it infects pregnant women.
Controlled observational clinical study following 179 female patients undergoing oocyte vitrification cycles in an academic fertility centre during the ZIKV epidemic in the French territories of the Americas. At the time, the French Ministry of Health issued a ban on medically-induced pregnancies. Oocyte vitrification cycles were the only means of preserving fertility options and ensuring Zika-free oocyte cryopreservation for currently exposed and/or recently infected patients. Samples of serum, urine, lower genital tract, endometrium, follicular fluid and immature oocytes were tested for ZIKV RNA (vRNA) by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Serological analysis for ZIKV antibodies was performed in succession for the duration of the study. The follow-up protocol was set up for more than 6 months post-exposure or post-onset.
No vRNA was detected in the various samples from exposed patients. Furthermore, no vRNA was found in the upper genital tracts of women with a recent (3 months) history of acute infection.
These findings represent evidence of a lack of vRNA persistence in the reproductive tract in ZIKV exposed and/or recently infected reproductive-age women and could help simplify current guidelines.
确定在上生殖道（特别是卵母细胞、卵泡液和子宫内膜）中是否存在暴露于寨卡病毒（ZIKV）或近期感染的育龄妇女局部感染寨卡病毒的风险。寨卡病毒是一种经蚊虫传播的黄病毒，如果孕妇感染寨卡病毒，可能导致出生缺陷和发育异常。
对 179 名在美洲法属领地寨卡病毒流行期间在一家学术生育中心接受卵母细胞玻璃化周期的女性患者进行的对照观察性临床研究。当时，法国卫生部发布了一项禁止医学诱导怀孕的禁令。卵母细胞玻璃化周期是唯一保留生育选择和确保为目前暴露于寨卡病毒或近期感染的患者提供无寨卡病毒的卵母细胞冷冻保存的方法。通过定量逆转录聚合酶链反应（qRT-PCR）检测血清、尿液、下生殖道、子宫内膜、卵泡液和未成熟卵母细胞中的寨卡病毒 RNA（vRNA）。在研究期间，对寨卡病毒抗体进行血清学分析。随访方案设定为暴露后或发病后超过 6 个月。
暴露患者的各种样本中均未检测到 vRNA。此外，在近期（3 个月）有急性感染史的妇女的上生殖道中也未发现 vRNA。
这些发现表明在暴露于寨卡病毒或近期感染的育龄妇女的生殖道中缺乏 vRNA 持续存在的证据，这可能有助于简化当前的指南。
