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Miscarriages and HPV

© Mischele Lewis

HPV has been linked to spontaneous abortions or miscarriages and may be the single most important factor since it can be prevented. HPV can be present even when the Pap smear is normal. It is worthwhile to have a Digene Test performed on a cervical swab in all cases of miscarriage to determine if HPV is present. Trophoblasts are the preferential target for human papilloma virus infection in spontaneously aborted products of conception. In a recent study it has been shown that human papillomavirus (HPV) infection was threefold more prevalent in miscarriage specimens compared with elective specimens (60% [15 of 25] v 20% [3 of 15], respectively) as analyzed by broad-spectrum.

In this study, archival paraffin-embedded tissue from a subset of previously analyzed miscarriage cases were reanalyzed by in situ PCR amplification so that the specific cells infected by HPV could be identified. In the current study, using a new PCR primer set for HPV, the status of six previously analyzed cases were verified (five HPV-positive and one negative). Furthermore, syncytiotrophoblasts were identified as the predominant cellular target of HPV..

Finally, four of four third-trimester placentas similarly analyzed gave no HPV-positive signal. Trophoblasts are the cell type that maintains placental contact with maternal tissue and through which nutrient exchange occurs. This knowledge prompts the hypothesis that HPV-infected trophoblasts may have altered characteristics, which may lead to a compromised gestation.”

Human papillomavirus is more prevalent in first trimester miscarried products of conception compared to elective specimens. In this study the possible role of human papillomaviruses (HPV) in miscarriages is addressed by assaying for HPV DNA in first trimester spontaneous and electively aborted products of conception materials enriched for chorionic villi. The presence of HPVs was measured by polymerase chain reaction amplification and DNA dot blot hybridization using an internal probe.

The 'broad spectrum' HPV primers were directed to amplify E6/E7 junction sequences, while the probe was of an HPV sequence with significant homology to HPV. The quantity and quality of isolated DNA was also analyzed and compared by observing the PCR amplification of a cellular sequence from the human beta-globin gene. Fifteen of the 25 spontaneous samples (60%) were found to be positive for HPV E6/E7 sequences. In comparison, only 3 of the 15 elective samples (20%) were positive. This is the first study of HPV in fetal materials to incorporate material from elective abortions as a control group.

Although confounding contamination from the cervix and vagina can't be ruled out, these data are significant and strongly suggest that HPVs are elevated in spontaneously aborted products of conception. Furthermore, these results suggest the possibility that HPVs may be etiologic agents of at least some spontaneous abortions.”