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Background  During the first trimester of pregnancy, HIV-1 mother-to-child transmission is relatively rare despite the permissivity of placental cells to cell-to-cell HIV-1 infection. The placenta interacts directly with maternal uterine cells (decidual cells) but the physiological role of the decidua in the control of HIV-1 transmission and whether decidua could be a source of infected cells is unknown.    Methodology/Principal Findings  To answer to this question, decidual mononuclear cells were exposed to HIV-1  in vitro . Decidual cells were shown to be more susceptible to infection by an R5 HIV-1, as compared to an X4 HIV-1. Infected cells were identified by flow cytometry analysis. The results showed that CD14 +  cells were the main targets of HIV-1 infection in the decidua. These infected CD14 +  cells expressed DC-SIGN, CD11b, CD11c, the Fc gamma receptor CD16, CD32 and CD64, classical MHC class-I and class-II and maturation and activation molecules CD83, CD80 and CD86. The permissivity of decidual tissue was also evaluated by histoculture. Decidual tissue was not infected by X4 HIV-1 but was permissive to R5 HIV-1. Different profiles of infection were observed depending on tissue localization.    Conclusions/Significance  The presence of HIV-1 target cells in the decidua  in vitro  and the low rate of  in utero  mother-to-child transmission during the first trimester of pregnancy suggest that a natural control occurs  in vivo  limiting cell-to-cell infection of the placenta and consequently infection of the fetus.

Antigen-Presenting Cells Represent Targets for R5 HIV-1 Infection in the First Trimester Pregnancy Uterine Mucosa