To the Editor.—
Kissing generally is considered protective sex.1 We do not agree, since the oral mucosa is very fragile. In fact, hepatitis B infection may occur by the oral route through microlesions present in the oral mucosa (inapparent-parenteral route)2,3 and not by the classic enteric route.4Since it is impossible to verify the presence of microlesions in the oral mucosa by inspection, we suggest that the presence of blood in saliva is indirect evidence of them.After encouraging preliminary results,5 we have verified this phenomenon by carrying out the following experiment.
Ninety healthy subjects (mean age, 25 years; range, 17 to 35 years) forming 45 heterosexual couples completed this study. Each subject was given six containers numbered 1 to 6 and was asked to collect saliva after carrying out the following three events in their normal way: immediately before and two or three
Piazza M, Chirianni A, Picciotto L, Guadagnino V, Orlando R, Cataldo PT. Passionate Kissing and Microlesions of the Oral Mucosa: Possible Role in AIDS Transmission. JAMA. 1989;261(2):244–245. doi:10.1001/jama.1989.03420020096022
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