Abstract
The potential risk of HIV-1 infection following human bite although epidemiologically insignificant, but it is biologically possible. There are anecdotal reports of HIV transmission by human bites particularly if saliva is mixed with blood. The oral tissues support HIV replication and may serve as a previously unrecognized HIV reservoir. The HIV infected individuals have more viruses in blood than saliva, possibly due to the potent HIV-inhibitory properties of saliva. The case presented here is of a primary HIV infections following a human bite where in the saliva was not blood stained but it got smeared on a raw nail bed of a recipient. The blood and saliva of the source and blood of the recipient showed a detectable viral load with 91% sequence homology of C2-V3 region of HIV gp120 between the two individuals. The recipient did not receive PEP [post exposure prophylaxis] as his family physician was unaware of salivary transmission. The family physician should have taken PEP decision after proper evaluation of the severe and bleeding bite. Hence it is necessary to treat the HIV infected human bites with post exposure prophylaxis.
Highlights
The epidemiological data has supported the premise that HIV transmission via saliva is low or non-existent due to inhibitory factors in saliva
Some patients are hyperexcretors [5] they have high levels of infectious HIV in their saliva than in blood. These hyper-excretors may be at risk of transmitting the virus to their partners even though the blood viral load is low
The blood samples of both the father-son duo and saliva of the source (Mr.X) were collected on 12 April 2010, these samples were analyzed for confirmation
Summary
The epidemiological data has supported the premise that HIV transmission via saliva is low or non-existent due to inhibitory factors in saliva. The risk of HIV-1 infection following human bite epidemiologically insignificant, but it is biologically possible [1,2]. The human bites as a rare risk factor for HIV transmission [4]. Some patients are hyperexcretors [5] they have high levels of infectious HIV in their saliva than in blood. These hyper-excretors may be at risk of transmitting the virus to their partners even though the blood viral load is low. An interesting case of HIV transmission following a human bite is reported. Clinical examination revealed a drowsy febrile patient without focal neurological deficit or meningeal signs. He was negative for HBV, HCV, and HSV. Details from patient revealed that his foster son (Mr.X) who was HIV-1
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