Role of the Placenta in Adverse Perinatal Outcomes among HIV-1 Seropositive Women

• Published in: Journal of Nippon Medical School Vol. 80; no. 2; pp. 90 - 94
• Main Authors: Ackerman, William, IV, Kwiek, Jesse J.
• Format: Journal Article
• Language: English
• Published: Japan The Medical Association of Nippon Medical School 2013
• Subjects: Chorioamnionitis - virology; Female; HIV Seropositivity - complications; HIV Seropositivity - transmission; HIV Seropositivity - virology; HIV-1 - physiology; human immunodeficiency virus type 1; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; low birth weight; placenta; Placenta - virology; placenta diseases; Pregnancy; Pregnancy Outcome; preterm birth
• ISSN: 1345-4676; 1347-3409
• DOI: 10.1272/jnms.80.90

Women seropositive for human immunodeficiency virus type 1 (HIV-1) are at an increased risk for a number of adverse perinatal outcomes. Although efforts to reduce mother-to-child transmission of HIV (MTCT) remain a priority in resource-limited countries, HIV testing and treatment have led to steep declines in MTCT in well-resourced countries. Even so, HIV seropositive pregnant women in the United States continue to deliver a disproportionately high number of preterm and low birth weight infants. In this mini-review, we address the role of the placenta in such HIV-related perinatal sequelae. We posit that adverse perinatal outcomes may result from two mutually non-exclusive routes: (1) HIV infection of the placenta proper, potentially leading to impaired maternal-fetal exchange; and (2) infection of the maternal decidual microenvironment, possibly disrupting normal placental implantation and development. Further research into the relationship between HIV-1 infection and placental pathology may lead to the development of novel strategies to improve birth outcomes among HIV-1 seropositive parturients.