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Journal of Virology, December 2003, p. 13301-13314, Vol. 77, No. 24
0022-538X/03/$08.00+0     DOI: 10.1128/JVI.77.24.13301-13314.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Human Cytomegalovirus Transmission from the Uterus to the Placenta Correlates with the Presence of Pathogenic Bacteria and Maternal Immunity

Lenore Pereira,1,2* Ekaterina Maidji,1 Susan McDonagh,1 Olga Genbacev,1 and Susan Fisher1,2,3,4,5

Departments of Stomatology,1 Anatomy,3 Pharmaceutical Chemistry,4 Biomedical Sciences Graduate Program,5 Oral Biology Graduate Program, University of California-San Francisco, San Francisco, California 94143-05122

Received 2 July 2003/ Accepted 3 September 2003

Prenatal cytomegalovirus infection may cause pregnancy complications such as intrauterine growth restriction and birth defects. How virus from the mother traverses the placenta is unknown. PCR analysis of biopsy specimens of the maternal-fetal interface revealed that DNA sequences from cytomegalovirus were commonly found with those of herpes simplex viruses and pathogenic bacteria. Cytomegalovirus DNA and infected cell proteins were found more often in the decidua than in the placenta, suggesting that the uterus functions as a reservoir for infection. In women with low neutralizing titers, cytomegalovirus replicated in diverse decidual cells and placental trophoblasts and capillaries. In women with intermediate to high neutralizing titers, decidual infection was suppressed and the placenta was spared. Overall, cytomegalovirus virions and maternal immunoglobulin G were detected in syncytiotrophoblasts, villus core macrophages, and dendritic cells. These results suggest that the outcome of cytomegalovirus infection depends on the presence of other pathogens and coordinated immune responses to viral replication at the maternal-fetal interface.

* Corresponding author. Mailing address: University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143-0512. Phone: (415) 476-8248. Fax: (415) 502-7338. E-mail: pereira{at}itsa.ucsf.edu.

Journal of Virology, December 2003, p. 13301-13314, Vol. 77, No. 24
0022-538X/03/$08.00+0     DOI: 10.1128/JVI.77.24.13301-13314.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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