Role of placenta in the vertical transmission of human immunodeficiency virus

Am, Al-Husaini

doi:10.1038/jp.2008.187

Cited by 37 publications

(18 citation statements)

References 57 publications

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“…Most participants were not married, unemployed, and for the most part were uneducated or had primary education. This conforms with other studies [18] Previous studies have reported very high prevalence of HIV amongst this group [19]. There is therefore need for expanded PMTCT programmes in Cameroon.…”

Section: Discussionsupporting

confidence: 92%

Cesarean delivery technique among HIV positive women with sub-optimal antenatal care uptake at the Douala General Hospital, Cameroon: case series report

et al. 2017

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BackgroundThe human immunodeficiency virus (HIV) pandemic is a serious public health problem worldwide, especially in low-income countries of sub-Saharan Africa (SSA). The prevention of mother to child transmission of HIV (PMTCT) is a major concern to those countries. Cesarean section has been described in the literature to be effective in the prevention of mother to child transmission (MTCT).Case series presentationWe present a series of seven cases of HIV positive pregnant women with sub-optimal antenatal care up-take who delivered by cesarean section at the Department of Obstetrics and Gynecology of the Douala General Hospital. During the cesarean section the fetal head was delivered through the uterine incision without rupture of amniotic membranes. The amniotic membranes were ruptured after delivery of the fetal head, and then the rest of the body was delivered.ConclusionsMost of the study participants had multiple risk factors for preterm labour. When a good cesarean section technique is used in women with high viral load and low CD4 counts, risk of MTCT HIV are greatly reduced even in low-income countries.

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Section: Discussionsupporting

confidence: 92%

Cesarean delivery technique among HIV positive women with sub-optimal antenatal care uptake at the Douala General Hospital, Cameroon: case series report

et al. 2017

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“…Maternal viral infection can result in transplacental passage of the virus. This has been well-described with rubella [90,91,120–125], cytomegalovirus [90,91,126–154], HIV [155–172], parvovirus [173–176] and others [143,177–189]. Ascending viral infection from the cervix into the amniotic cavity can also occur, as is the case with herpes virus type 2 [183,190], human papilloma virus (HPV) [191–195] and others [99,142].…”

Section: Discussionmentioning

confidence: 99%

Viral invasion of the amniotic cavity (VIAC) in the midtrimester of pregnancy

Gervasi¹,

Romero²,

Bracalente³

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

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The prevalence of viral infections in the amniotic fluid (AF) has not yet been ascertained. The aim of this study was to determine the prevalence of specific viral nucleic acids in the AF and its relationship to pregnancy outcome. Study design From a cohort of 847 consecutive women undergoing midtrimester amniocentesis, 729 cases were included in this study after exclusion of documented fetal anomalies, chromosomal abnormalities, unavailability of AF specimens and clinical outcomes. AF specimens were tested by quantitative real-time PCR for the presence of genome sequences of the following viruses: adenoviruses, herpes simplex virus (HSV), varicella zoster virus (VZV), human herpesvirus 6 (HHV6), human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), parvovirus B19 and enteroviruses. Viral nucleic acid testing was also performed in maternal blood and cord blood in the population of women in whom AF was positive for viruses and in a control group of 29 women with AF negative for viral nucleic acids. The relationship between the presence of viruses and pregnancy and neonatal outcome was examined. The correlation between the presence of nucleic acids of viruses in the AF and the concentration of the cytokine interleukin-6 (IL-6) and the T cell chemokine CXCL-10 (or IP-10) in AF and maternal blood were analyzed. Results Viral genome sequences were found in 16 of 729 (2.2%) AF samples. HHV6 was the most commonly detected virus (7 cases, 1.0%), followed by HCMV (6 cases, 0.8%), parvovirus B19 (2 cases, 0.3%) and EBV (1 case, 0.1%), while HSV, VZV, enteroviruses and adenoviruses were not found in this cohort. Corresponding viral DNA was also detected in maternal blood of six out of seven women with HHV6-positive AF and in the umbilical cord plasma, which was available in one case. In contrast, viral DNA was not detected in maternal blood of women with AF positive for parvovirus B19, HCMV, EBV or of women with AF negative for viruses. HHV6 genome copy number in AF and maternal blood was consistent with genomic integration of viral DNA and genetic infection in all women. There was no significant difference in the AF concentration of IL-6 and IP-10 between patients with and without VIAC. However, for HCMV, there was a significant relationship between viral copy number and IP-10 concentration in maternal blood and AF. The group of women with AF positive for viral DNA delivered at term healthy neonates without complications in 14 out of 16 cases. In one case of HHV6 infection in the AF, the patient developed gestational hypertension at term, and in another case of HHV6 infection in the AF, the patient delivered at 33 weeks after preterm premature rupture of membranes (PPROM). Conclusion Viral nucleic acids are detectable in 2.2% of AF samples obtained from asymptomatic women in the midtrimester. HHV6 was the most frequently detected virus in AF. Adenoviruses were not detected. Vertical transmission of HHV6 was demonstrated in one case.

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“…At the same time HIV-1 also has been identified on both the maternal and the fetal parts of the placenta and shown to be replicated in the placenta. The virus may cross the trophoblastic barrier by endocytosis, or by an injured villous surface [12]. There are reports that this transmission requires cell to cell contact and it has been speculated that T cell to placenta contact could be responsible for infection of trophoblast by HIV-1 and this was inhibited by anti-LFA-1 antibodies [13].…”

Section: Introductionmentioning

confidence: 99%

“…Perinatal transmission of HIV-1 has been characterized by selection of specific genotype variants in the infected infants that escapes mother’s immune system [14]. It is also known that concomitant placental infection may increase the risk of placental transmission of HIV-1 to the fetus [12].…”

Section: Introductionmentioning

confidence: 99%

HIV-1 Nef Breaches Placental Barrier in Rat Model

et al. 2012

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The vertical transmission of HIV-1 from the mother to fetus is known, but the molecular mechanism regulating this transmission is not fully characterized. The fetus is highly protected by the placenta, which does not permit microbial pathogens to cross the placental barrier. In the present study, a rat model was established to observe the effect of HIV-1 protein Nef on placental barrier. Evans blue dye was used to assay permeability of placental barrier and fourteen day pregnant Sprague Dawley rats were injected intravenously with 2% Evans blue dye along with various concentrations of recombinant Nef. After an hour, animals were sacrificed and dye migration was observed through the assimilation of peripheral blood into fetus. Interestingly, traces of recombinant Nef protein were detected in the embryo as well as amniotic fluid and amniotic membrane along with placenta and uterus. Our study indicates that recombinant HIV-1-Nef protein breaches the placental barrier and allows the migration of Evans blue dye to the growing fetus. Further the concentration of Nef protein in blood is directly proportional to the intensity of dye migration and to the amount of Nef protein detected in uterus, placenta, amniotic membrane, amniotic fluid and embryo. Based on this study, it can be concluded that the HIV-1 Nef protein has a direct effect on breaching of the placental barrier in the model we have established in this study. Our observations will be helpful to understand the molecular mechanisms related to this breach of placental barrier by Nef in humans and may be helpful to identify specific Nef inhibitors.

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Role of placenta in the vertical transmission of human immunodeficiency virus

Cited by 37 publications

References 57 publications

Cesarean delivery technique among HIV positive women with sub-optimal antenatal care uptake at the Douala General Hospital, Cameroon: case series report

Cesarean delivery technique among HIV positive women with sub-optimal antenatal care uptake at the Douala General Hospital, Cameroon: case series report

Viral invasion of the amniotic cavity (VIAC) in the midtrimester of pregnancy

HIV-1 Nef Breaches Placental Barrier in Rat Model

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