Journal d'immunologie clinique et cellulaire
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Transplacental Infection of HIV-1 and the Associated Risk Factors In Utero

Shamala Moodley

Background: Identifying risk factors in “in utero” transmission of human immunodeficiency virus type 1 (HIV-1) is important when designing preventive interventions. Several lines of evidence suggest that Natural Killer (NK) cells have an important role in antiviral defence. However, the Human Leucocyte Antigen-G (HLA-G) molecules are inhibitory of these cell-mediated immune responses and could, therefore, promote the propagation of HIV-1 infection across the placental interface thus increasing the risk of vertical transmission.

Study design: A total of 55 women were enrolled into the study. Tests for viral loads, CD+4 counts, Natural Killer cells, p24 and HLA-G1 expression were performed. Using logistic regression analyses, a study of the risk factors were undertaken.

Results: Variables associated with in utero transmission were HIV-1 viral load and HLA-G1 expression. Mothers, with low haemoglobin values, were more at risk in transferring the virus to their babies. The tendency for the presence of high NK cells was indicative of improved immunity.

Conclusions: Patients, with low haemoglobin, were more likely to transfer the virus to their foetus. Viral RNA was a strong predictor of mother-to-child-transmission (MTCT). The expression of HLA-G1 was an additional risk factor in acquiring HIV-1 infection. Female babies were more at risk than male babies with MTCT.