Role of placenta in the vertical transmission of human immunodeficiency virus

Objective: Review the role and mechanism of in utero placental transmission of HIV-1. Study Design: A thorough review based on a literature search for publications relevant to this subject was performed using relevant search terms. Articles that describe the genetic and pathophysiology of vertical transmission have been acknowledged. The articles pertinent to the topic were selected to support the discussion. Results: Vertical transmission may occur through CD4+ endothelial tissues or CD4+ Hofbauer cells. Trophoblasts and villi have CD4 receptors, which make them potential candidates for HIV infection. Placental cytokines and chemokines influence HIV replication in trophoblasts. Genetic analysis of HIV-1 sequences verify the interaction of HIV-1 and placental tissue. The vertical transmission of HIV-1 characterized by selection of genotype variant that escape the mother's immune system. Conclusion: Placental transmission of HIV-1 is a complex incompletely understood process which requires advanced studies. The available literature provides information with regards to the interactions of placental cells with HIV. Journal of Perinatology (2009) 29, 331-336; doi:10.1038/jp.2008.187; published online 20 November 2008