HIV Transmission Through Gastric Secretions
HIV transmission through gastric secretions does not occur under normal circumstances, as gastric secretions (stomach acid and digestive fluids) are not considered potentially infectious for HIV. 1
Body Fluids That Are NOT Infectious for HIV
According to U.S. Public Health Service guidelines, the following fluids are not considered potentially infectious unless they contain visible blood: 1
- Feces
- Nasal secretions
- Saliva
- Sputum
- Sweat
- Tears
- Urine
- Vomitus (including gastric contents)
The risk for HIV transmission from these fluids and materials is low. 1
Body Fluids That ARE Potentially Infectious
In contrast, the following are considered potentially infectious for HIV: 1
- Blood and visibly bloody body fluids
- Semen and vaginal secretions
- Cerebrospinal fluid
- Synovial fluid
- Pleural fluid
- Peritoneal fluid
- Pericardial fluid
- Amniotic fluid
Important Caveats About Gastric Exposure
Newborn Gastric Aspirates
While gastric secretions themselves are not infectious, there is one specific scenario worth noting: 2
- HIV has been detected in newborn gastric aspirates after delivery, reflecting swallowed maternal cervicovaginal secretions and blood during birth
- Two of four HIV-infected neonates in one study had positive gastric aspirate cultures 2
- The presence of HIV in newborn gastric aspirates may be a risk factor for perinatal infection 2
- However, this represents exposure to cervicovaginal secretions and blood (which are infectious), not gastric secretions per se 2
Gastric Achlorhydria in HIV Patients
HIV-associated gastric achlorhydria (reduced stomach acid production) may facilitate acquisition of enteric bacterial infections in HIV-infected persons, but this relates to susceptibility to other pathogens, not HIV transmission itself. 1
Clinical Bottom Line
Gastric secretions do not transmit HIV. 1 Healthcare workers and others exposed to vomitus or gastric contents from HIV-infected individuals do not require post-exposure prophylaxis unless these fluids contain visible blood. 1 The only exception to consider is the perinatal setting where newborn gastric aspirates may contain swallowed maternal blood and cervicovaginal secretions during delivery. 2