In a report released Monday, US researchers say they have “compelling evidence” that three infants became infected with HIV, the virus that causes AIDS, by eating food prechewed by their HIV-infected caregivers.

The mothers of two of the three children were known to be infected with HIV, but the mothers had not breastfed their babies and mother-to-child transmission of HIV had been ruled out. The mother of the third infant was not infected with HIV, but a great aunt who helped care for the child was.

All three children were fed food on multiple occasions that had been prechewed by a care provider infected with HIV, Dr. Aditya H. Gaur from St. Jude Children’s Research Hospital in Memphis, Tennessee and colleagues note in the latest issue of the journal Pediatrics.

The team ruled out other ways the babies could have become infected, and further investigations revealed that the primary source of HIV in two of the cases was likely bleeding in the mouth of the adult infected with HIV who prechewed the food.

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.

Until the risk of HIV transmission via prechewed food is better understood, they recommend against the practice for anyone infected with HIV or at risk of HIV infection.

SOURCE: Pediatrics, August 2009.