09 February 2011
By Menaka Rao
HIV, according to experts, is not normally transmitted through saliva. Transmission of the virus from the host is possible when saliva is mixed with blood.
In an unusual case, which should make the experts revisit their earlier position, a 50–year–old man has contacted HIV through his son’s saliva.
The man was bitten by his 32–year–old HIV positive stepson. But the latter did not have ulcers in his mouth, which usually leads to saliva getting mixed with blood.
Documented instances speak of the presence of the virus in saliva, but transmission takes place only in the above case.
"The son had pulled out the thumb nail of his father. Since the wound was raw, the virus could enter easily," said Dr Alaka Deshpande, who runs the Centre of Excellence ART clinic at JJ hospital. The patient had come to her last year.
To understand the case better, the doctors wanted to verify if the father carried the same virus that has infected his son. Deshpande then sent the patient to National Institute of Research in Reproductive Health for further testing.
Dr AH Bandivdekar and Dr Shivaji Jadhav from the department of biochemistry and virology did gene sequencing of the HIV virus in the father and the son’s blood and concluded that both viruses were the same. "This confirmed the source of the HIV virus. Also, the son’s saliva had a high viral load which may have also caused the transmission," said Dr Deshpande.
Unfortunately, the father was not given post exposure prophylaxis (PEP), a short–term anti–retroviral treatment given to reduce the likelihood of HIV infection after potential exposure. The family doctor told him that the virus cannot spread via saliva.
"He was admitted to JJ hospital for meningitis. After four days, he told us about this history. His blood was then sent for HIV testing and he was discovered HIV positive," said Deshpande. She stressed that family physicians should know about HIV infected human bites and should treat it with PEP, in which the treatment should start within two hours of the potential exposure.
The father’s viral load was more than 20 lakh then. "He was treated as per US guidelines so that the virus does not spread to other organs. After treatment his viral load came down." This case study was presented at the International Conference on Emerging Frontiers and Challenges in HIV/AIDS Research by Dr Jadhav to show that HIV infected human bites should be treated with PEP.
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