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(C2) Saliva, Breast Milk, and Mucosal Fluids in HIV Transmission

K. Page-Shafer^1,*, S. Sweet², S. Kassaye³, and C. Ssali⁴

¹ Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
² Dept. of Oral Medicine, Pathology, Immunology and Microbiology, GKT Dental Institute, London, UK
³ Division of Infectious Disease, Stanford University School of Medicine, Palo Alto, CA, USA; and
⁴ Ministry of Health, Kampala, Uganda

Correspondence: ^* corresponding author, shafer{at}psg.ucsf.edu

The oral environment has received various amounts of attention in association with HIV infection and pathogenesis. Since HIV infection occurs through mucosal tissue, oral factors—including tissue, fluids, and compartments—are of interest in furthering our understanding of the diagnosis, infectivity, transmission, and pathogenesis of disease. This report reviews: (1) HIV testing and diagnoses with oral fluids; (2) post-natal acquisition of HIV in association with breast-feeding from HIV-positive mothers; and (3) oral sex and HIV transmission. In the first, we examine how oral fluids are used to detect HIV infection and review current consensus on the role of salivary molecules as markers for immunosuppression. Second, lactation-associated HIV acquisition is reviewed, with special consideration of emerging issues associated with the impact of anti-retroviral therapies. Last, we consider current data on the risk of HIV infection in association with oral sex. Investigation of these diverse topics has a common goal: understanding how HIV presents in the oral environment, with an aim to rapid and accessible HIV diagnosis, and improved prevention and treatment of infection.

KEY WORDS: HIV • saliva • breast-feeding • oral mucosa • oral fluid • post-natal transmission