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Studies on the Placental Transfer of Cell-Free Human Immunodeficiency Virus and p24 Antigen in an Ex Vivo Human Placental Model

OBJECTIVE: We studied whether the human placenta has the structural integrity to impede transplacental passage of cell-free human immunodeficiency virus (HIV)-1 or p24 antigen from the maternal to the fetal circulation. METHODS: Nine term human placentas from uncomplicated vaginal or cesarean section deliv eries were studied ex vivo with a placental perfusion apparatus to determine whether cell-free HIV-1 at 200-2000 tissue culture infectious dose (TCID50/mL) would pass to the fetal circu lation. Passage of virus or p24 was assessed by infectivity titration and/or p24 antigen capture enzyme immunoassay. RESULTS: Infectious HIV-1 was not detected in any of the fetal perfusate samples taken periodically during experiments. Low concentrations of HIV-1 p24 antigen, however, were detected in fetal perfusate samples from three placentas. CONCLUSIONS: The term human placenta effectively impedes passage of cell-free HIV-1 from the maternal to the fetal circulation. However, it may be permeable to passage of p24 anti gen. (J Soc Gynecol Invest 1994;1:45-8)