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Marcello Piazza, MD; Antonio Chirianni, MD; Ludovico Picciotto, MD; Vincenzo Guadagnino, MD; Raffaele Orlando, MD; Pietro Tullio Cataldo, MD
Clinica Malattie Infettive Secondo Policlinico Naples

JAMA. 1989;261(2):244-245.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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.⁴

Since 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.

Study. —

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 . . . [Full Text PDF of this Article]

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