Fetal cord blood mononuclear cells that are collected at term from HIV-1 infected women harbor transcriptionally active integrated proviral DNA

Abstract

The purpose of this study was to determine levels of intrauterine infection and transcriptional activity in cord blood mononuclear cells that were collected at term from fetuses who were born to women who were infected with human immunodeficiency virus (HIV) and who received highly active antiretroviral therapy (HAART). RNA and DNA were isolated from maternal placental tissues and fetal cord blood specimens that were obtained at term from pregnant women who were infected with HIV and who received HAART. Levels of integrated HIV provirus and messenger RNA transcripts were determined by real-time polymerase chain reaction. Detectable levels of transcriptionally active integrated provirus were present in approximately 27% of cord blood samples (n = 22) that were collected from fetuses who born to HIV-positive mothers who received HAART. Levels of HIV-p24 antigen in cultures that were detected in randomly selected cord blood samples confirmed the presence of inducible infectious virus. These findings suggest that some fetuses from HIV-infected mothers who receive HAART and who may be HIV-negative infants after delivery can harbor circulating leukocytes that are infected productively by intrauterine transmission of HIV.