The study, led by Dr. Aditya Gaur, an assistant member of St. Jude Children's Research Hospital's Infectious Disease department, is published in the August edition of the journal Pediatrics.
Here's an excerpt from the press release about the detective work involved in this study:
The case that led to this published report 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," Gaur said. Also, genetic testing, led by Kalish at the CDC, showed 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," Gaur said.
When Gaur contacted Dominguez at the CDC about the possible case of transmission via pre-chewed food, the center alerted him to two similar cases previously reported by senior author Mitchell and colleague Rivera from the University of Miami. Those cases were not reported to the public at the time because of the lack of sufficient evidence of transmission via pre-chewed food. One case involved pre-chewing by an HIV-infected mother, and the other an HIV-infected aunt who was the caregiver.
A Reuters story picks up on a couple of interesting implications of this study:
Although the practice of prechewing food for young children has been described in various parts of the world, including the United States, the extent of this practice is not well known, Gaur and colleagues admit.
Still, prechewed food is a route of HIV transmission "not previously reported" and one that has "important global implications," they emphasize.
Furthermore, Gaur and colleagues say the practice of feeding prechewed food to infants -- which some caregivers may do during the weaning period -- may also explain some of the reported cases of "late" HIV transmission in infants -- cases so far attributed to breastfeeding.
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