Table 1.

Case reports of suspected or allegedly confirmed HIV transmission by human bite

Case	Authors, year of publication (reference)	Bite victim				Circumstances of bite	Aggressor			HIV-type relatedness (victim/aggressor) assessed by authors	Authors´ assessment of causality of bite and transmission
		Sex, age (years), history	Bite location	Wound features	Seroconversion or acute HIV infection		Relationship with   victim, sex, age (years), risks	HIV status at the time of bite	CD4 cells/ml blood, VL: HIV RNA  copies/ml
1	Wahn et al. (1986) [6]	Male, 8	Forearm	Teeth imprints, no bleeding or haematoma	Not reported	Possibly seizure	Brother, 5	AIDS	Not reported	Not evaluated	Bite likely route
2	Anonymous (1987) [7]	Female, 26	Leg	Not reported	Seronegative ~ 1.5 years before bite, seropositive ~ 2 years  after bite	Fight, leading to a teeth loss of aggressor and bleeding mouth	Sister, IV drug abuse	HIV infection known	Not reported	Not evaluated	Bite most likely route
3	Vidmar et al. (1996) [8]	Male, 53	Left index-finger nail	Small crack and shallow wound, teeth imprints, no visible bleeding	Acute infection, seroconversion 54 days after bite	Seizure, bite wound on aggressor´s tongue and blood in saliva	Neighbour, male, 47	AIDS	High level of HIV copies in plasma 11 months earlier, at the  time of bite on zidovudine treatment	Not evaluated	Case shows that HIV transmission is possible by bite
4	Anonymous (1996) [9] Liberti et al. (1996) [10]	Male, 91	Hand, arm, leg	Severe tissue damage	Seroconversion within 6 weeks after bite	Fight, dental problems, bleeding gums	Robber, female prostitute	HIV infection  known	Not reported	Confirmed a	Evidence support HIV transmission by bite
5	Khajotia et al. (1997) [11]	Male, 20	Lip	Cut inside of the lower lip with taste of blood	Seroconversion following negative tests over 7 months after bite	Deep kiss during a night club visit	Call girl, one time contact	HIV status unknown	Not reported	Not evaluated	Male virgin contracted HIV by lip bite
6	Andreo et al. (2004) [12]	Female, 59, widow	Hand	Deep wound needing suture	Acute infection, seroconversion  40  days after bite	Seizure, blood in the mouth	Son, 31	AIDS	Not reported	Confirmed b	Unequivocal evidence
7	Bartholome et al. (2006) [13]	Female, 3	Middle finger of left hand	Bleeding at the site of bite	Seropositive ~ 4 years after bite	Bite reason not reported, dental caries, bleeding gums	Father	HIV status unknown, AIDS 3 years after bite	Not reported	Not evaluated	HIV infection believed to be a direct result from bite
8	Uzoigwe et al. (2007) [14]; Akani et al. (2007) [15]	Female, 30, pregnant	Upper lip	Bleeding injury necessitating suturing	Seronegative shortly prior to bite, seropositive ~ 16 months after bite	Fight	Sister in law, commercial sex worker	HIV infection known, no symptoms	Not reported	Not evaluated	HIV infection is associated with the bite
9	Deshpande et al. (2011) [16]; Jadhav 2018 [17]	Married man 44, diabetes mellitus	Left thumb	Nail lost with raw bleeding nail bed	Acute infection, VL 2,470,000 copies/ml 28 days after bite	Argument, good oral hygiene, no bleeding oral lesions	Foster son	HIV infection known, no symptoms	CD4 cells: 383, VL plasma: 17,163, VL saliva: 2,405 VL salivary cells: 161	Confirmedc	Possible
10	Thomas et al. (2019) [18]	Male, 56	Left cheek and thumb	Deep injuries, thumb fracture	Acute infection, VL 1,023,292 ( 6.01 log10) copies/ml 41 days after bite	Fight, blood-stained saliva from bite injuries	Not reported, 34	HIV infection known	VL 200 (2.3 log10) 29 days after the bite while on ART since 6 weeks prior to the bite	Confirmedd	Confirmed
11	Schürmann et al. (2020), case report of this article	Unmarried man, 42, alcohol use	Ball of left hand	Bleeding gapping wound	Seronegative 7 days after bite, seropositive 97 days after bite	Argument	Acquaintance, male, 23, IV drug use	HIV infection known, no symptoms	CD4 cells: 243, VL plasma: 176,000 5 weeks prior to bite	Probablee	Probable

ART antiretroviral therapy, IV intravenous, VL viral load. Cases listed in the chronological order which they were reported. Data listed where available. Further information displayed in the text

^aDNA sequencing showed a close genetic relationship of HIV-1 strains from bite victim and aggressor (no detailed data given), consistent with person-to-person transmission; ^bboth viruses belonging to HIV-1 clade B, same quasispecies of bite victim and aggressor; ^c91% homology of the C2-V3 region of gp120 , HIV-1C env gene with 5 NLG sites in bite victim and 6 NLG sites in aggressor, presence of single NLG site at V3 region of HIV-1C env gene in bite victim and aggressor; ^dHIV-1 comparison showed 99% homology of the reverse transcriptase and protease amino acids. ^eOn the basis of an usual mutation rate, the time of HIV-1 transmission or strain identity of aggressor and bite victim, respectively, was calculated to be 42 months prior to blood drawal for virus comparison. The factual time between assumed virus transmission by bite and blood drawal was 27 months