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Transmission questions...
Jan 21, 2014

Dear Doc,

A couple of questions,

1) Since we know that there is an enzyme in saliva that prohibits the evolution of the virus, why wasn't there ever an effort to induce this enzyme somehow in the human body in order to slow down the progress of the virus??

2)Since the beginning of the hiv epidemic probably there would have been millions of unprotected sexual contacts between a heterosexual man and an +hiv woman, what is the essential key factor that determines transmission to a man from a woman???...i'm interested in Western world (US,Europe)...... in reality how possible is that??and i'm talking solely about the insertive partner engaging in vaginal sex....have you ever come across to a man been infected from one time exposure having vaginal sex???...to let you know these are only theoretical questions, i'm a condoms fan...

Response from Dr. Wohl

I am not so sure the enzymes in saliva are the key to why HIV is not acquired during oral sex. The mouth also harbors antibodies and these too may play a role. Some vaccines are being developed to promote such antibodies in the genital tract so they can pounce on virus when exposures occur.

Men can be infected by women. We see that clearly in Africa. In US and Europe risk is less but not zero. Recall that infection is dependent on multiple factors including infectiousness of the source, the susceptibility of the host, the infectivity of the virus and the inoculum (how much virus is involved in the exposure). Things happen and the stars can align such that a virus can pass from a woman to a man.

DW



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