First three cases of HIV infection have suggested that the deadly virus could be transmitted from mothers or other caregivers to children via pre-chewed food, according to researchers led by an Indian-origin scientist.
Led by Dr. Aditya Gaur, of St. Jude Children's Research Hospital, the researchers have uncovered the above three cases, and found that the source of HIV in the pre-chewed food was most likely the infected blood in the saliva of the people who pre-chewed the food before giving it to the children.
The findings indicated that HIV-infected mothers or other caregivers should be warned against giving infants pre-chewed food, and directed toward safer feeding options.
The cases indicate that physicians and clinics should routinely include questions about pre-chewing food in their health screening of infant caregivers who have HIV or are suspected of the infection.
Also, possible cases of HIV transmission through pre-chewed food should be reported to public health agencies to help increase understanding of the prevalence of such transmission.
Gaur said that the already it is known that giving infants pre-chewed food could transmit infections like streptococcus and the hepatitis B virus, there was evidence that the blood-borne HIV could be similarly transmitted until the discovery of the above cases.
He said that the source of blood in the saliva of the person pre-chewing the food for the child could have been visible or microscopic bleeding from the gums or some other part of the mouth.
In the study, the researchers described three cases in which pre-chewed food was likely the source of HIV transmission to infants.
The case that led to the study was a 9-month-old infant who was referred to St. Jude because she was HIV positive after earlier tests had been negative.
"Her HIV-positive mother had not breastfed her, and further investigation had ruled out transmission by blood transfusion, injury or sexual abuse," said Gaur.
The genetic testing revealed that the daughter had been infected with the same HIV strain as the mother.
"Fortunately, the St. Jude nurse practitioner, Marion Donohoe, was very thorough in her questioning about feeding practices, and she asked about pre-mastication. It turned out this mother had fed her daughter pre-chewed food," said Gaur.
After that he encountered two similar cases previously reported by senior author Mitchell and colleague Rivera from the University of Miami.
One case involved pre-chewing by an HIV-infected mother, and the other an HIV-infected aunt who was the caregiver.
Gaur said that information in the three cases suggests that one factor aiding such transmission was mouth bleeding in the caregiver, as well as in the infant due to teething or infection.
The findings of the study have been published in the journal Pediatrics.