Pityriasis rosea, HHV-6, and the increased risk of miscarriage

Pityriasis rosea, HHV-6, and the increased risk of miscarriage

Pityriasis rosea (PR) is an acute rash associated with HHV-6 & 7 reactivation. According to a group of dermatologists in Italy, a suprising 62% of women who developed PR early in their pregnancies miscarried, and HHV-6 DNA was found in fetal tissue of 3 out of 4 stillborns tested.

The investigators from University of Milano-Bicocca, Italy, studied 61 women who developed PR during pregnancy; 22 of them had adverse outcomes including 8 miscarriages. They were able to assess 14 of the patients and four of the aborted fetuses for HHV-6 and 7 DNA.  HHV-6 DNA was found in the plasma, the placenta, lesions and fetal tissue of 3 out of 4 PR patients with stillborns.

An earlier Japanese study published in Lancet found that HHV-6 IgG and IgM antibody titers were four times higher in women with spontaneous abortion during weeks  6-12 of pregnancy. Furthermore, HHV-6 antigen was found in the abortive villous tissue of 2 out of 3 IgM positive patients, suggesting that reactivation of HHV-6 during the first trimester may predispose women to spontaneous abortion (Ando 1992).

Caroline Hall’s group at University of Rochester studied HHV-6 in the cord blood of over 5,000 infants and only found HHV-6 DNA in infants with ciHHV-6, or in children whose mothers had ciHHV-6 (Hall 2010). The Italian group was not able to determine ciHHV-6 status in these stillborns or of the mothers with pityriasis rosea.

A UK study of viral infection in fetal death found viral DNA in of 34% of aborted fetal tissues compared to none in elective pregnancy terminations. In that study, CMV was found in 20 and HHV-6 & 7 were found in 5 of the 73 cases (Al-Buhtori 2011).

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