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RÉSUMÉ
Introduction. Le Virus de l’Herpès Humain-6 (HHV-6) a été retrouvé impliqué dans l’infertilité féminine. L’objectif de notre étude était d’évaluer le profil virologique du HHV-6 et les variations cytokiniques y associées chez les femmes enrôlées pour une fécondation in vitro. Méthodologie. Une étude transversale analytique a été menée au Centre Hospitalier de Recherche et d’Application en Chirurgie Endoscopique et en Reproduction Humaine du 01 Mai 2021 au 30 Avril 2022 soit 12 mois. Au total, 92 participantes ont été inclues consécutivement. Les variables ont été comparées à l’aide d’un test de Chi² ou le test T de Student grâce au logiciel SPSS version 27 avec pour seuil statistiquement significatif, p<0,05. Résultats. Dans notre étude, 63/92 (68,5%) étaient en latence, 17/92 (18,4%) en réactivation systémique et 1/92 femme (1,1%) en réactivation locale. Aucune donnée clinique n’était associée à l’infection par le HHV-6 (p≥0,05). Du jour du transfert au jour du test de grossesse, il y avait une augmentation d’IL-10 en cas de réactivation du HHV-6 (3,66 [1,27-17,41]) et une diminution en cas de non-réactivation (-0,54 [-4,45-2,66]) (p=0,010). Par contre, les variations de l’IFN-Gamma n’étaient pas associées à un profil du HHV-6. Conclusion. La réactivation du HHV-6 systémique était retrouvée dans 2/10 cas et la locale dans 1/10 cas. Elle était associée à une augmentation de l’IL-10 du jour de transfert au jour du test de grossesse. L’impact de ce virus en Assistance Médicale à la Procréation reste à démontrer.
ABSTRACT
Introduction. Human Herpes Virus-6 (HHV-6) has been found to be involved in female infertility. The objective of our study was to evaluate the virological profile of HHV-6 and the associated cytokine variations in women enrolled for in vitro fertilization. Methodology. An analytical cross-sectional study was carried out at the Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction from May 1, 2021 to April 30, 2022, i.e. 12 months. In total, 92 participants were included consecutively. The variables were compared using a Chi square test or the Student's T test using SPSS version 27 software with a statistically significant threshold of p<0.05. Results. In our study, 63/92 (68.5%) were in latency, 17/92 (18.4%) in systemic reactivation and 1/92 women (1.1%) in local reactivation. No clinical data were associated with HHV-6 infection (p≥0.05). From the day of transfer to the day of pregnancy testing, there was an increase in IL-10 in case of HHV-6 reactivation (3.66 [1.27-17.41]) and a decrease in case of no -reactivation (-0.54 [-4.45-2.66]) (p=0.010). On the other hand, variations in IFN-Gamma were not associated with an HHV-6 profile. Conclusion. Systemic HHV-6 reactivation was found in 2/10 cases and local in 1/10 cases. It was associated with an increase in IL-10 from the day of transfer to the day of the pregnancy test. The impact of this virus on Medically Assisted Reproduction remains to be demonstrated.
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References
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- - Organisation mondiale de la Santé (OMS). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
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- - Okafor NI, Joe-Ikechebelu NN, Ikechebelu JI. Perceptions of Infertility and In Vitro Fertilization Treatment among Married Couples in Anambra State, Nigeria. Afr J Reprod Health. 2017;21(4):55-66.
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- - Voundi JV, Belinga E, Voundi EV, Ndoua CN, Nyada S, Ngono V, Sahmo SS, Mviena, LN, Tsague N, Toukam M. Seroprevalence of the Human Immunodeficiency Virus and impact on fertility in couples at the Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Cameroon. Journal of Advance Research in Pharmacy & Biological Science. 2022;8(4): 9-14.
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- - Bortolotti D, Gentili V, Rotola A, Cultrera R, Marci R, Di Luca D, Rizzo R. HHV-6A infection of endometrial epithelial cells affects immune profile and trophoblast invasion. Am J Reprod Immunol. 2019;82(4):e13174.
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- - Aimola G, Beythien G, Aswad A, Kaufer BB. Current understanding of human herpesvirus 6 (HHV-6) chromosomal integration. Antiviral Res. 2020;176:104720.
- - Miura H, Kawamura Y, Ohye T, Hattori F, Kozawa K, Ihira M, Yatsuya H, Nishizawa H, Kurahashi H, Yoshikawa T. Inherited Chromosomally Integrated Human Herpesvirus 6 Is a Risk Factor for Spontaneous Abortion. J Infect Dis. 2021 May 28;223(10):1717-1723.
- - Gervasi MT, Romero R, Bracalente G, Chaiworapongsa T, Erez O, Dong Z, Hassan SS, Yeo L, Yoon BH, Mor G, Barzon L, Franchin E, Militello V, Palù G. Viral invasion of the amniotic cavity (VIAC) in the midtrimester of pregnancy. J Matern Fetal Neonatal Med. 2012;25(10):2002-13.
- - Bortolotti D, Gentili V, Santi E, Taliento C, Vitagliano A, Schiuma G, Beltrami S, Rizzo S, Lanza G, Rizzo R, Gafà R, Greco P. Late-onset intrauterine growth restriction and HHV-6 infection: A pilot study. J Med Virol. 2021;93(11):6317-6322.
- - Secchiero P, Carrigan DR, Asano Y, Benedetti L, Crowley RW, Komaroff AL, Gallo RC, Lusso P. Detection of human herpesvirus 6 in plasma of children with primary infection and immunosuppressed patients by polymerase chain reaction. Journal of Infectious Diseases. 1995;171(2), 273-280.
- - Bosselut H, Paulmyer-Lacroix O, Gnisci A, Bretelle F, Perrin J, Courbiere B. Facteurs pronostiques des chances de naissance vivante en fécondation in vitro pour infertilité inexpliquée : étude de cohorte. Gynécologie Obstétrique Fertilité & Sénologie. 2021; 49(7–8), 601-607.
- - Adedigba JA, Idowu BM, Hermans SP, Ibitoye BO, Fawole OA. The relationship between hysterosalpingography findings and female infertility in a Nigerian population. Pol J Radiol. 2020;13(85):e188-e195.
- - Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res Pract. 2020;6(1):20.
References
- WHO. Infertility. Available at: https://www.who.int/fr/news-room/fact-sheets/detail/infertility (consulté le 18 Mai 2021)
- Organisation mondiale de la Santé (OMS). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
- Tabong PT, Adongo PB. Understanding the social meaning of infertility and childbearing: a qualitative study of the perception of childbearing and childlessness in Northern Ghana. PLoS One. 2013;8(1):e54429.
- Hess RF, Ross R, Gililland Jr JL. Infertility, psychological distress, and coping strategies among women in Mali, West Africa: a mixed-methods study. African journal of reproductive health. 2018;22(1):60-72.
- Okafor NI, Joe-Ikechebelu NN, Ikechebelu JI. Perceptions of Infertility and In Vitro Fertilization Treatment among Married Couples in Anambra State, Nigeria. Afr J Reprod Health. 2017;21(4):55-66.
- Obajimi GO, Saanu O, Ilesanmi AO. Expanding access to assisted reproductive technology in a developing country: getting more for less. African Journal of Medicine and Medical Sciences. 2021;50(2):171-175.
- Egbe TO, Mbaki CN, Tendongfor N, Temfack E, Belley-Priso E. Infertility and associated factors in three hospitals in Douala, Cameroon: a cross-sectional study. African Health Sciences. 2020;20(4) : 1985-1995.
- Belley PE, Tchenté Nguefack C, Nguemgne C, Nana Njamen T, Taila W, Banag E. L’infertilité à l’hôpital général de Douala : Aspects épidémiologiques et radiologiques (à propos de 658 cas). Journal Afrique imagerie médicale. 2015;2(7):16-23.
- Guena MN, Ketcha ST, Zilbinkai FA, Fotsing JG. Profil épidémio clinique, échographique et hystérosalpingographique de l’infertilité féminine à l’Hôpital Régional de Ngaoundéré. Journal Africain d'Imagerie Médicale. 2019;10(4).
- Voundi JEV, Ndoua CN, Voundi EV, Belinga E, Nyada S, Ngono V, Nyimbe Mviena L, Ayangma CR, Kamga Nogue R, Nguefack Tsague, Toukam M. Hepatitis B virus seroprevalence and impact on fertility in couples at the Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Cameroon. Journal of Advance Research in Medical & Health Science. 2022;8(4):10-16.
- Voundi JV, Belinga E, Voundi EV, Ndoua CN, Nyada S, Ngono V, Sahmo SS, Mviena, LN, Tsague N, Toukam M. Seroprevalence of the Human Immunodeficiency Virus and impact on fertility in couples at the Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Cameroon. Journal of Advance Research in Pharmacy & Biological Science. 2022;8(4): 9-14.
- Coulam CB, Bilal M, Salazar Garcia MD, Katukurundage D, Elazzamy H, Fernandez EF, Kwak-Kim J, Beaman K, Dambaeva SV. Prevalence of HHV-6 in endometrium from women with recurrent implantation failure. Am J Reprod Immunol. 2018;80(1):e12862.
- Bortolotti D, Gentili V, Rotola A, Cultrera R, Marci R, Di Luca D, Rizzo R. HHV-6A infection of endometrial epithelial cells affects immune profile and trophoblast invasion. Am J Reprod Immunol. 2019;82(4):e13174.
- Marci R, Gentili V, Bortolotti D, Lo Monte G, Caselli E, Bolzani S, Rotola A, Dario Di Luca D, Rizzo R. Presence of HHV-6A in endometrial epithelial cells from women with primary unexplained infertility. PloS One. 2016;11(7):e0158304.
- Bodemer C. Exanthèmes fébriles de l’enfant : orientation diagnostique. Vers les étiologies les plus fréquentes. 2007;10(5):318-325.
- Aimola G, Beythien G, Aswad A, Kaufer BB. Current understanding of human herpesvirus 6 (HHV-6) chromosomal integration. Antiviral Res. 2020;176:104720.
- Phan TL, Lautenschlager I, Razonable RR, Munoz FM. HHV-6 in liver transplantation: A literature review. Liver Int. 2018;38(2):210-223.
- Agut H, Bonnafous P, Gautheret-Dejean A. Laboratory and clinical aspects of human herpesvirus 6 infections. Clin Microbiol Rev 2015;28(2):313-35.
- Aimola G, Beythien G, Aswad A, Kaufer BB. Current understanding of human herpesvirus 6 (HHV-6) chromosomal integration. Antiviral Res. 2020;176:104720.
- Miura H, Kawamura Y, Ohye T, Hattori F, Kozawa K, Ihira M, Yatsuya H, Nishizawa H, Kurahashi H, Yoshikawa T. Inherited Chromosomally Integrated Human Herpesvirus 6 Is a Risk Factor for Spontaneous Abortion. J Infect Dis. 2021 May 28;223(10):1717-1723.
- Gervasi MT, Romero R, Bracalente G, Chaiworapongsa T, Erez O, Dong Z, Hassan SS, Yeo L, Yoon BH, Mor G, Barzon L, Franchin E, Militello V, Palù G. Viral invasion of the amniotic cavity (VIAC) in the midtrimester of pregnancy. J Matern Fetal Neonatal Med. 2012;25(10):2002-13.
- Bortolotti D, Gentili V, Santi E, Taliento C, Vitagliano A, Schiuma G, Beltrami S, Rizzo S, Lanza G, Rizzo R, Gafà R, Greco P. Late-onset intrauterine growth restriction and HHV-6 infection: A pilot study. J Med Virol. 2021;93(11):6317-6322.
- Secchiero P, Carrigan DR, Asano Y, Benedetti L, Crowley RW, Komaroff AL, Gallo RC, Lusso P. Detection of human herpesvirus 6 in plasma of children with primary infection and immunosuppressed patients by polymerase chain reaction. Journal of Infectious Diseases. 1995;171(2), 273-280.
- Bosselut H, Paulmyer-Lacroix O, Gnisci A, Bretelle F, Perrin J, Courbiere B. Facteurs pronostiques des chances de naissance vivante en fécondation in vitro pour infertilité inexpliquée : étude de cohorte. Gynécologie Obstétrique Fertilité & Sénologie. 2021; 49(7–8), 601-607.
- Adedigba JA, Idowu BM, Hermans SP, Ibitoye BO, Fawole OA. The relationship between hysterosalpingography findings and female infertility in a Nigerian population. Pol J Radiol. 2020;13(85):e188-e195.
- Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res Pract. 2020;6(1):20.