United Press International - Wednesday, 11 July 2001
Ed Susman, UPI Science News

Doctors at the Hospital de Ninos Sor Maria Ludovica in La Plata, Argentina, said molecular testing on the virus from the child and from his father showed the strains were nearly identical, evidence that "horizontal" transmission from father to child had occurred.

"In-house or accidental transmission of HIV among family members is so exceedingly rare that any such case deserves to be reported," said Dr. Julio Montaner, professor of infectious diseases at the University of British Columbia, Vancouver.

Montaner is chairman of the scientific committee that arranged the first International AIDS Society Conference on HIV Pathogenesis and Treatment in Buenos Aires, Argentina, where the study was reported.

"There were mentions of possible in-house transmission in the early days of the epidemic," Montaner told United Press International, "but this is the first such scientific-supported report that I am aware of." Lead author of the study, Ana Ceballos, a research scientist in the microbiology department of the Argentine National Reference Center for AIDS at the University of Buenos Aires, performed the genetic and molecular testing on the family and found the child's mother, two brothers and sister did not have human immunodeficiency virus or HIV, which causes acquired immune deficiency syndrome or AIDS. The research team also discounted the possibility of sexual assault against the child.

"We are now redoing the tests just to make sure that the samples were not contaminated in the laboratory," she told UPI. "The epidemiological and molecular data strongly suggest that horizontal transmission has occurred, probably related to the close father-child contact."

The father, an intravenous drug abuser and alcoholic, also has spent time in prison. He suffers from liver disease, which Ceballos said might compromise the wound healing process.

"He has ulcers and other open wounds on his hands, and we think blood from these wounds somehow infected the child," she said. However, Dr. Silvia Gonzalez Ayala, a co-author of the report and the child's doctor at Hospital de Ninos, told UPI, "I'm not convinced that this is a case of horizontal transmission. I can't prove it, but I think this might be a case of vertical transmission through an infected germinal -- sperm cell -- of the father."

Gonzalez Ayala, professor of infectious diseases at the National University of La Plata, suggested that because the mother is not infected and the 3-year-old child has a history of AIDS-like diseases since he was 6-months-old, that the sperm that fertilized the mother's egg was infected with the virus from the father and the child was actually infected at conception.

There has never been a confirmed report of vertical transmission from father to child, Montaner said. Vertical transmission of HIV occurs often when infected mothers transmit the virus to their babies either while the child is in the womb or at birth.

Montaner said even though in-house transmission is also rare, "in this case it makes more sense that it occurred through accident than through germinal cell infection. I would think that it would be more likely the husband would infect the mother if he was capable of infecting the sperm cell that was involved in conception."

The answer may come from other investigations undertaken by Ceballos and Gonzalez Ayala. The team is looking at three other Argentine cases in which the father and child are infected but the mother is not.

Dr. I.S. Gilada, a specialist in skin diseases and AIDS in Mumbai (Bombay) India, said the researchers should look more closely at the relationship between the father and child to definitively rule out some form of sexual contact or the possibility of needlestick injury involved in clandestine drug use.

"However," Gilada said, "this could be a situation in which the answer is unanswerable."

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