# Suspected dog bite associated HIV horizontal transmission in Swaziland


## TL;DR

A suspected case of HIV transmission through dog bites in Swaziland raises concerns about the risk of bloodborne viruses during such incidents.

## Contribution

This paper highlights a potential for HIV transmission through dog bites and suggests clinicians consider bloodborne viruses in such cases.

## Key findings

- An HIV-positive guard transmitted the virus to another guard through a dog bite.
- The second victim showed HIV seroconversion despite post-exposure prophylaxis.
- The case suggests clinicians should consider bloodborne virus risks in successive dog bites.

## Abstract

Dog bites may lead to transmission of bacteria and viruses over and above
tetanus and rabies. Theoretically human immunodeficiency virus (HIV),
Hepatitis B and Hepatitis C may be transmitted after dog bites where
transfer of blood from one victim to another occur in clinical practice HIV,
Hepatitis B and Hepatitis C are not considered when making treatment
decisions, nor adequate patient history taken to consider all potential
risks after dog bites in succession.

To present case of suspected HIV transmission after dog bites in close
succession involving two HIV sero-discordant victims.

Management and outcome: HIV rapid test and/or HIV Ribonucleic acid (RNA)
polymerase chain reaction (PCR) results for the victim(s) at presentation
and a month later.

Two night patrol guards presented to casualty after dog bites in close
succession by the same dog. They were managed according to the dog bite
protocol. Thinking out of the box, the first victim was found to be HIV
positive by rapid test whilst the second victim was negative based on both
HIV rapid test and HIV RNA PCR. One month after the dog bites, a case of HIV
sero-conversion was confirmed in the second victim despite post-exposure
prophylaxis (PEP).

Although an isolated case, shouldn’t clinicians re-think the significance of
HIV transmission after animal bites where there is repeated blood exposure
in several people in succession?

Clinicians should be aware of the potential of HIV, Hepatitis B and C
transmission, when faced with dog bites in succession.