Abstract
Editor: We carefully read the interesting article published by Ezeonwumelu et al., regarding an accidental father-to-son HIV-1 transmission 1 ; this topic, although controversial, should be further addressed for the implications it might have for HIV discordant couples at the time of pregnancy.
There is a remote possibility that the newborn has actually acquired the infection during the first days of life, from his father; nonetheless, the possibility of vertical transmission, being the father the source of infection, should not be ignored.
The sperm cells could have transferred the virus during the interaction with the oocyte. The child was born in April 2009; therefore, the conception was around June/July of 2008. Even, the estimated for the determination of time to the most recent common ancestor (tMRCA) showed that the boy became HIV infected at a later date than the father for all analyzed genomic fragments (mean tMRCA gag in boy = March 2011, in father = November 2008; pol in boy = April 2010, in father = November 2008; env in boy = August 2010, in father = November 2007). The infection of the father could have been in November 2007 (based on env), even, in November 2008, which is very close to June/July that is the approximate date of the interaction between the sperm and the oocyte.
So far, several reported cases have discussed the possibility of vertical HIV father to child transmission: one in France in 1998, two in Argentine in 2004, one in India in 2013, one in China, and one in Portugal, in the recent mentioned article. 1
In the article of Salvatori et al., 2 the authors postulated that the child's infection was possibly because of her exposure to bleeding skin lesions on the father. In addition, Ezeonwumelu et al. 1 also postulated that the infection of the reported child might have occurred by accidental contact during her first days of life when her umbilical cord could have been in contact with large vesicles caused by varicella zoster and syphilis that her father was suffering from.
Furthermore, others authors postulate that the child was infected by contact with blood or other body fluid from the father, as he usually had dermatitis on his hand. Ceballos et al. 3 presumed that transmission apparently resulted from an unrecognized exposure to blood or secretions between the father and his offspring. Nevertheless, Murugan et al. 4 hypothesized that sperm cells could be a vector for HIV.
In agreement with previous studies, we found HIV DNA in pure sperm cells from HIV-positive men. Also, several studies showed that sperm cells may be able to attach and transport exogenous DNA molecules know as exogenes. In addition, we show that HIV and spermatozoa in vitro interaction can be mediated by the mannose receptor, and we finally confirmed that the spermatozoa are able to transfer the virus to susceptible cells in vitro, inducing a productive infection.
Based on this evidence, in daily clinical practice it is essential for serodiscordant couples—that is, women are HIV negative and men are HIV positive—to determine the HIV status in the baby as it was postulated previously.