[Question #10611] Hepatitis B and C risk

21 months ago

Hello doctors,

I have recently learned that I have not received the vaccine for hepatitis B as a child, and to my knowledge have not been tested for it as my local sexual health clinic does not offer testing for Hep B and C. I had a full blood test (CRP, liver function, CBC, WBC, urea recently and everything is fine. I also had a complete abdominal ultrasound. I plan on getting checked for peace of mind, but what are the chances that I have been living with hepatitis for 3 years without it showing on regular blood tests?

I am an anxious hypochondriac and recently had a STD scare. Because of it, I ended up panic buying a rapid at home STI test from Amazon. The lancet is a non safety one and it looks cheap, and product description states that the manufacturer is Chinese, but does not provide company name. Is it possible to contract Hep B and/or C from this lancet? It arrived sealed with the usual lancet cap to twist and break, but my concerns are if it got infected at the factory during production what are my chances of being infected.

Edward W. Hook M.D.

21 months ago

Welcome to our Forum. Thanks for your question. Thanks as well for acknowledging your hypochondria. From the information you have provided I see little reason for concern about hepatis B but the correct way to address your concern is to see a clinician who can order a hepatitis screen. The results of the test will help you to understand whether or not you have ever had hepatitis.

Regarding the nature of the test you ordered on line, while such tests may or may not provide reliable results, there are no instances in which persons have acquired hepatitis B (or C) from using the sorts of lancets you describe.

Again, my advice is to see your physician and get a hepatitis screen. EWH

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21 months ago

Hello Dr Hook,

Thank you for your reply and for the service that both you and Dr Handsfield provide.

I have an appointment for Hepatitis B and C test on Wednesday, so hopefully that will put an end to my sleepless nights.

Regarding the lancet, am I right in assuming that even if the lancet was contaminated during manufacture, that the time between the potential infection, the production process, storage and shipping of it plus the amount of days it probably sat in the warehouse before being shipped to me, would make it highly unlikely if not impossible for the virus to then infect me as it would either have died or at worse, it would not be as contagious anymore to pose a significant risk of Hepatitis B, C and HIV developing? Am I overreacting by thinking of going on PeP for this?

Thank you

Edward W. Hook M.D.

21 months ago

You are correct. In the very unlikely circumstance that the lancet were contaminated, any contamination would no longer be infectious after manufacturing, packaging, transport and delivery. PEP would be a mistake. If you approached me for PEP, I would decline to provide it.

Please don’t worry. EWH

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21 months ago

Hello again Dr Hook,

My last question is just in hopes of easing my anxiety. I had STI rapid tests performed in clinic this week (the test is provided by Better2Know, I do not have much information about it, but they have been operating in the UK for years) and the samples have been collected in a private health clinic in London. I have no specific, rational reason to believe my results are not genuine as my potentially risky exposure was in November 2021. It was unprotected vaginal and oral sex (no ejaculation) with someone that to the best of my knowledge has tested negative for all diseases (he shared test results with me, his test was checked by an NHS lab and he is a doctor himself).

I received negative results at the clinic for HCV, HBV, Chlamydia, Gonorrhea and Syphilis. For my HIV test I used the Biochem Sure Check test kit at home. Last year I also tested negative for Chlamydia and Gonorrhea through the NHS. What are the odds that all my results are false negatives? Is further testing required to confirm results?

Personally I’d rather not go through the stress and constant worry again, but I am finding it difficult to manage my anxiety. Do you have any suggestions on how to deal with it and stop worrying over my test results?

Thank you

Edward W. Hook M.D.

21 months ago

Given the information you have provided the odds of your tests being falsely negative are one in many millions. There is simply no realistic chance that you have an STI, including HIV. There is no need for testing.

In situations such as yours where a person is having difficulty moving forward following an exposure they have come to worry about or even regret, further testing rarely solves the problem. Rather the best approach is often to discuss the basis for your fears, worries and possible guilt with a trained, professional, confidential counselor.

Take care. There should be no need for further questions on this topic EWH

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21 months ago

Hello,

I am sorry to be back here and even more sorry that I am mostly likely over stressing and overthinking.

I have mentioned in my previous question a possible risky exposure that happened 2 years ago with someone HIV negative (I saw his test results, but now I am even questioning if those were not false negatives, as they were provided by Sexual Health London (SHL) and there are quite a few bad reviews about them issuing out false positives with their postal kits).

I also failed to mention a potential risky exposure I had around the same time in 2021. Unprotected oral sex with someone whose HIV status is unknown, unfortunately ejaculation was present. I did not test after this encounter because I believed it to be low risk, but now I am panicking after everything I’ve read about there being significant documented cases of HIV infection from this.

With that being said, the only test I had for HIV so far was the Surecheck instant one, which is a reputable test for over 90 days of exposure, which is the case for me at around 24 months. My question now is, can I trust that the result I got is accurate? I’ve read that potentially the only other thing that could interfere and generate a false negative is biotin. I take a supplement that contains 50micrograms of biotin, is that enough to interfere with the rapid test result? I am waiting 48 hours to test again without biotin, or is it better to wait 72? Do I absolutely need to go for another test, a blood drawn one from vein, or can I rest assured I am negative and seek counseling for my OCD/hypochondria?

Edward W. Hook M.D.

21 months ago

The thread should have been closed, preventing further questions. It was not so you will get additional brief comments following which the thread will be closed. There should be no need for further questions.

Your follow-ups suggest that your OCD/hypochondria is getting the best of you as well as that you have been to the internet looking for information. Please stay off the internet- it is not edited and therefore you have no way to know what is true and what is not. Many of our clients are misled by information there that is out of date, misinterpreted, taken out of context, inappropriately amplified or just plain wrong. Please stay off the internet for health related matters.

The additional exposure you mention was extraordinarily low risk. Most heterosexual men do not have HIV and the estimated risk of acquiring HIV from an untreated HIV infected man through fellatio is less than 1 infection per 10,000 sex acts (i.e. like performing oral sex on an untreated infected person daily for nearly 30 years). that combined with your negative test so long after the exposure make your risk for HIV virtually zero. Further, the amount of biotin you take is far too little to effect the performance of HIV tests.

I urge you to put your concerns behind you. If you choose to test again (which in my opinion is unnecessary), I assure you the test will be negative. You need to move forward, not worry about the past. Work with your counselor on your OCD

this completes this thread. EWH

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