HIV-1 infection of first-trimester and term human placental tissue: a possible mode of maternal-fetal transmission.

To understand the potential role of placental tissue in the pathogenesis of neonatal AIDS, the distribution of human immunodeficiency virus type 1 (HIV-1) receptor and the infectability of placental tissue by HIV-1 were studied. Both the mRNA and the protein for the HIV receptor (CD4) were present in fetal-derived placenta. By immunofluorescent microscopy, a number of different cell types appeared to be CD4+; positive cells were observed in the lining and stroma of the chorionic villi. Some of these CD4+ cells dual-labeled with the trophoblastic marker placental lactogen. In addition, CD4+ cells were observed within the lining of placental blood vessels. Organ cultures of first-trimester and term placentas were infectable by HIV as monitored by reverse transcriptase activity of culture supernatants and by immunofluorescent labeling of HIV antigens. One potential route of congenital HIV transmission may be direct placental infection by HIV as early as the first trimester, with subsequent transplacental spread of the virus.