Infertility and human herpesvirus 6: A guide for healthcare providers

In the quest to better treat patients with unexplained infertility, research implicating human herpesvirus 6 (HHV-6) as an important cause offers hope of new therapies. In fact HHV-6 has been found in as many as 43% of women in these cases, which is prompting a new approach to examination priorities.

Indeed since the spread of the Zika virus in 2015, abnormalities in babies born from infected mothers became a key concern and the issue enjoyed considerable attention in medical circles. Yet HHV-6 stands out as a major concern. A range of gestational problems are often associated with the presence of HHV-6, such as spontaneous abortions, gestational hypertension and premature births.

From the perspective of healthcare providers, many Doctors recognize that HHV-6 may well be the cause of their patients’ unexplained infertility hence early stage testing and subsequent anti-viral treatment is now considered to be a prudent approach in modern medicine.

Understanding the importance of HHV-6 testing:

In addition to a growing body of worldwide research, a more recent study published in PLOS Pathogens confirmed that HHV-6 was present in 43% of women who experienced unexplained infertility (Marci R, et al, 2016). Other researchers who weighed in on this, explained that more specifically, the HHV-6A infection of the endometrium triggers an abnormal NK cell and cytokine profile, which in turn leads to a uterine environment that is not compatible with implantation.

Dr. Konstance Knox, CEO of Coppe Laboratories, who is also a leading American virologist, confirmed the importance of the study: “These findings do not surprise me. I have been working with the human herpesviruses for the past 30 years and have come to understand the ‘personality’ of HHV-6. Upon reactivation due to hormonal changes, immunosuppression and/or certain drugs, HHV-6 will disrupt its local environment. The cascade of changes that occur can make the uterus an inhospitable environment for implantation and fetal development.”

 

 

 

 

Ensuring effective testing:

A key differentiator in treatment that may lead to better results begins with accurate testing. This is because the virus is only detected in uterine epithelial cells and not in blood samples using traditional HHV-6 testing methods. Traditional blood tests are simply not sufficient during this critical step.

At Coppe Laboratories, they make use of Immunohistochemical (IHC) staining for HHV-6. This proprietary testing, called TRAc-6, is the most sensitive method for detection of active viral replication in tissue samples. Currently, this may well be the highest probability of ensuring accurate test results for patients.

 

 

TRAc-6 testing at Coppe Laboratories:

Samples taken by endometrial biopsy are fixed, embedded and sectioned. These sections are then placed on slides and tested at the lab by protein staining. The sample requirements are 6 unstained slides, 4 microns formalin-fixed, paraffin embedded (FFPE) tissue. The testing has a turnaround time of 7 business days.

 

Which patients should be tested for HHV-6?

Given the growing evidence of a strong link between HHV-6 and infertility, it is prudent to test anyone who presented with unexplained infertility, repeat failure to implant and multiple miscarriages.

 

Conclusion:

Putting a patients’ needs first by considering up to date research is essential in today’s world. We now know that HHV-6 can be an ever more serious factor in unexplained infertility. Coppe Laboratories is currently the only reference laboratory that carries out comprehensive testing for HHV-6 on blood, hair follicle, nail clippings and tissue. Physicians can work with Coppe Labs to make a difference in one of the most important areas of their patients’ lives, which is the ability to start a family.