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Oral transmission of HIV, reality or fiction? An update

Profile image of Antonio Bascones- MartinezAntonio Bascones- Martinez

2006, Oral Diseases

Abstract
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This paper addresses the ongoing debate regarding the oral transmission of HIV. It presents data on the prevalence of HIV globally and highlights the risks associated with various body fluids, especially saliva, in the context of HIV transmission. The authors review existing literature on the inhibitory activities of different body fluids and conclude that while some body fluids exhibit anti-HIV properties, the risk of oral transmission remains controversial and requires further investigation.

Figures (3)
“Only studies performed from 1990 to date are included. Case reports are not included. MSM, men who have sex with men; POI, passive oral intercourse; AOI, active oral intercou Table 2. Epidemiological studies on oral transmission of HIV since 1990" (adapted from Rothenberg et a/, 1998)
“Only studies performed from 1990 to date are included. Case reports are not included. MSM, men who have sex with men; POI, passive oral intercourse; AOI, active oral intercou Table 2. Epidemiological studies on oral transmission of HIV since 1990" (adapted from Rothenberg et a/, 1998)
et al, 2003). They showed for the first time that HIV-1 induces expression of /-—defensins on human oral epithelial cells and that f-defensins block HIV replica- tion by direct interaction with the virions and by modulation of the CXCR4 coreceptor (Quinones-Mateu et al, 2003). women and the ribonuclease also found in their urine can completely block HIV replication and reduce HHV-8-induced tumours (e.g. Kaposi’s Sarcoma). Hypothetically, these proteins could act jointly to attack HIV, with lysozymes destroying viral mem- branes while ribonucleases block reproduction of the virus by destroying its genetic material, although concentrations above physiological levels would be required (McNeely et a/, 1995). Saxena et al (1996) found a ribonuclease homologous to RNase A named onconase that inhibited virus replication in chronically HIV-1 infected human cells without killing virally infected cells (Saxena et al, 1996). Cystatins, present in saliva, have also demonstrated a certain inhibitory activity against HIV, whereas statherin and amylase have no blocking effects on replication of the virus (Bergey et al, 1994). In addition, lactoperoxidase released by neutrophils inactivates HIV-1 by the production of hypothiocyanite (Yamaguchi ef al, 1993). A further two proteins with inhibitory capacity detected in saliva are SAG and mucin MGz2, which bind to and displace gp120 from virions giving rise to defective viral particles that cannot infect host cells (Nagashunmugam et al, 1998), with MG2 being the most active protein (Shugars et al, 2002). Table 4 lists the numerous salivary proteins with antiviral and anti-microbial properties. In 1999, Ameri- can scientists discovered that the urine, tears and saliva of pregnant women contain two proteins with potent anti-HIV inhibitory effects (lysozyme and ribonuclease). Furthermore, both types of protein are present in a pregnancy hormone called human chorionic gonadot- ropin (HCG) and transmission of the virus is extremely rare during the first term of pregnancy, when HCG levels are especially high (Lee-Huang et al, 1999). Lactoferrin, secreted by neutrophils and exocrine glands, is found in saliva, maternal milk, tears, semen and other mucosal secretions. It can inhibit HIV replication, both when iron-saturated and when not, and it can also interfere with the adhesion and entry of HIV to host cells (Puddu ef al, 1998). Secretory leucocyte protease inhibitor (SLPI) has been isolated in human parotid secretions (Thompson and Ohlsson, 1986). It is a non-glycosylated protein In vitro studies have shown that the lysozyme protein found in the tears, saliva and urine of pregnant
et al, 2003). They showed for the first time that HIV-1 induces expression of /-—defensins on human oral epithelial cells and that f-defensins block HIV replica- tion by direct interaction with the virions and by modulation of the CXCR4 coreceptor (Quinones-Mateu et al, 2003). women and the ribonuclease also found in their urine can completely block HIV replication and reduce HHV-8-induced tumours (e.g. Kaposi’s Sarcoma). Hypothetically, these proteins could act jointly to attack HIV, with lysozymes destroying viral mem- branes while ribonucleases block reproduction of the virus by destroying its genetic material, although concentrations above physiological levels would be required (McNeely et a/, 1995). Saxena et al (1996) found a ribonuclease homologous to RNase A named onconase that inhibited virus replication in chronically HIV-1 infected human cells without killing virally infected cells (Saxena et al, 1996). Cystatins, present in saliva, have also demonstrated a certain inhibitory activity against HIV, whereas statherin and amylase have no blocking effects on replication of the virus (Bergey et al, 1994). In addition, lactoperoxidase released by neutrophils inactivates HIV-1 by the production of hypothiocyanite (Yamaguchi ef al, 1993). A further two proteins with inhibitory capacity detected in saliva are SAG and mucin MGz2, which bind to and displace gp120 from virions giving rise to defective viral particles that cannot infect host cells (Nagashunmugam et al, 1998), with MG2 being the most active protein (Shugars et al, 2002). Table 4 lists the numerous salivary proteins with antiviral and anti-microbial properties. In 1999, Ameri- can scientists discovered that the urine, tears and saliva of pregnant women contain two proteins with potent anti-HIV inhibitory effects (lysozyme and ribonuclease). Furthermore, both types of protein are present in a pregnancy hormone called human chorionic gonadot- ropin (HCG) and transmission of the virus is extremely rare during the first term of pregnancy, when HCG levels are especially high (Lee-Huang et al, 1999). Lactoferrin, secreted by neutrophils and exocrine glands, is found in saliva, maternal milk, tears, semen and other mucosal secretions. It can inhibit HIV replication, both when iron-saturated and when not, and it can also interfere with the adhesion and entry of HIV to host cells (Puddu ef al, 1998). Secretory leucocyte protease inhibitor (SLPI) has been isolated in human parotid secretions (Thompson and Ohlsson, 1986). It is a non-glycosylated protein In vitro studies have shown that the lysozyme protein found in the tears, saliva and urine of pregnant

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