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In general, the risk of contracting HIV (human immunodeficiency virus) through being bitten or by biting another person is actually quite low. A number of different variables can influence the actual risk of contracting the virus.

If neither the biter nor the person being bitten are infected with HIV, then the risk of transmission is, of course, zero. If one person does carry HIV in their bloodstream, however, things get a bit more complicated.

There are a couple of different things that must be considered here. One is what is called the "viral load". Simply put, this is the number of viral particles actually circulating in the infected person's bloodstream. If the viral load is high, then it stands to reason that there is a greater chance of HIV particles being transmitted during the bite.

The second thing that must be considered is whether the infected blood came in contact with the non-infected person's blood at any time during the bite. If a non-infected person bites an infected person, even if the infected person has a high viral load of HIV in the blood, the chances of that infected blood finding its way into an open sore or other wound in the mouth of the biter is relatively low. Similarly, an infected biter would have to have blood in his or her mouth to transmit infection to an non-infected "bitee", even if the bite broke the skin.

Despite the relatively low risk here, my general practice is to obtain an "exposure panel" on the non-infected person as soon as possible after the bite to establish their baseline status - whether they are infected with several communicable diseases like Hepatitis B, Hepatitis C, and HIV - at the time of the bite. The CDC then recommends that the tests be repeated several times over the coming months. Some sources recommend testing serially at the time of the bite, then at 1, 3, 6, and 12 months following the bite, and this is the schedule I use.

No prophylactic (preventive) treatments are currently recommended by the CDC for bites. Instead, their recommended use is limited to what are called "high-risk" exposures, like a needlestick with a large-gauge, hollow-bore needle that has been recently used on a person with known HIV infection and a high viral load.

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16y ago

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