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Article ; Online: HIV Transmission Through Premastication.

Nash, Sarah H / Rutledge, Molly / Frenkel, Lisa M / Melvin, Ann J / Laws, Peyton / Klejka, Joseph / Hirschfeld, Matthew

Pediatrics

2022  Volume 150, Issue 4

Abstract: Premastication is a potential route of transmission of HIV from caregiver to child. We report the case of a 13-month-old Alaska Native child from rural Alaska who presented with failure to thrive, recurrent pneumonias, severe dental decay, and dysphagia. ...

Abstract Premastication is a potential route of transmission of HIV from caregiver to child. We report the case of a 13-month-old Alaska Native child from rural Alaska who presented with failure to thrive, recurrent pneumonias, severe dental decay, and dysphagia. The mother was HIV-uninfected. Respiratory failure prompted transfer to a children's hospital outside of Alaska where the child received a diagnosis of HIV infection. A grandparent who had been acting as primary caregiver was discovered to be HIV-infected with detectable viral load resulting from intermittent nonadherence to her medication regimen. This grandparent reported feeding the child premasticated food. Sequencing of the hypervariable C2V5 region of the HIV envelope gene in both patients demonstrated less than 0.05% variation, consistent with transmission from grandparent to child. Health care providers should be aware that transmission of HIV can occur via premastication, educate parents and caregivers regarding this risk, and rigorously pursue HIV testing when indicated even in children with HIV-uninfected mothers.
MeSH term(s) Caregivers ; Child ; Female ; Food ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Mastication ; Mothers
Language English
Publishing date 2022-09-02
Publishing country United States
Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID 207677-9
ISSN 1098-4275 ; 0031-4005
ISSN (online) 1098-4275
ISSN 0031-4005
DOI 10.1542/peds.2021-055422
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