[Question #10826] Hepatitis and HPV risk
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19 months ago
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Hello doctor.
A little over 3 months ago I had protected oral and vaginal sex with a female sex worker in the US.
If during the entire encounter a condom was used is there any risk of me (male) getting hepatitis a, b, c or HPV and transmitting it to another partner?
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19 months ago
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I would like to add I was tested for hepatitis a, b and c one month ago which all came back negative however during routine labs this week my doctor said I have elevated enzyme levels. Should I get tested for hepatitis again?
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Edward W. Hook M.D.
19 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The exposure you describe was very low risk. Most CSWs do not have STIs and even when they do, even most unprotected exposures do not lead to infection. In your case, the exposure was condom protected, there was no evidence that the condom failed (when condoms fail, they break wide open and the failure is obvious), and you have negative tests. I would have no concern that this encounter led to any blood borne infection.
Additional comments:
Hepatitis C is virtually never sexually transmitted with the occasional exception of to persons engaged in receptive rectal intercourse.
even then infection is rare.
HPV does not cause elevation of liver enzymes. Most sexually active persons already have HPV and it is an innocuous process. Condoms reduce the risk for HPV, I would not worry about HPV.
Summary- I would not be worried about STIs from the exposure you describe. I see no medical or sceintitic reasn for further testing. I would encourage you to move forward without concern. Nothing you describe suggests that your encounter put your regular partner at risk.
EWH
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19 months ago
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Thank you for your response. Would a negative test for hepatitis b be accurate enough 9 weeks after the exposure if I’m on immunosuppressant medication?
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Edward W. Hook M.D.
19 months ago
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Depending on the immunosuppressant, probably.
EWH
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19 months ago
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I’m currently taking prednisone, Tacrolimus and myfortic.
I believe I received the hepatitis b vaccine as a child but that was over 15 years ago. In May 2022 I got a blood test for hepatitis b surface antibody ql test that came back reactive. My doctor at the time said that means I was either vaccinated for hepatitis b or had the virus at some point and now I’m immune to it. Is that correct?
Based on this information do you believe I should take another hepatitis b and c test even though I used a condom during the entire encounter?
Sorry for the long response. I’m just scared the elevated liver enzymes could be caused by my indiscretion and don’t want to put my regular partner at risk.
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Edward W. Hook M.D.
19 months ago
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We provide up to three responses for each client's questions. This is my 3rd response.
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1. Your encounter was protected and virtually no risk
2. Most CSWs do not have HIV. In the U.S. HIV-2 is vanishingly rare, with only a handful of cases reported each year
3. Even most single encounters with infected partners do not result in infection. Your encounter was condom protected.
4. Hepatitis B infection or vaccine provides lifelong immunity, even for persons taking immunosuppressive therapy. Your may test shows that you are NOT at risk for hepatitis B
5. There are many causes of elevated LFTAs, including some of the medications you are taking.
I urge you to accept that you do not have viral hepatitis and move forward. Your partner is NOT at risk from your indiscretion. You need to move on.
This ends this thread. There should be no need to return regarding the encounter you have described. EWH