Frequent and early in utero HIV-1 infection

We have investigated in utero human immunodeficiency virus type 1 (HIV-1) transmission by analyzing human fetal tissues for the presence of viral DNA by means of the polymerase chain reaction (PCR). Thirty three fetal samples: thymus, spleen, and peripheral mononuclear blood cells (PMBC) were obtained at abortion (16 to 24 weeks) from HIV-1-infected asymptomatic women. The results of HIV-1-DNA detection were considered only in 9 cases where contamination of fetal samples by infected mother cells could be definitely eliminated by using primers specific for a polymorphic cellular locus. PCR allowed the identification of HIV-1 DNA sequences in 6/8, 8/9, and 5/9 of specimens from thymus, spleen, and PMBC, respectively. Positive results were shown in fetuses as early as 16 weeks. Viral cultures as well as assays for serum p24 HIV-1 antigen were negative in 9.9 and 33/33 tested, respectively. Therefore, our results indicate early and frequent in utero HIV-1 infection. Different patterns of viral activation after birth might then lead to either rapid or delayed onset of acquired immunodeficiency syndrome.