[Question #10896] Hepatitis B

18 months ago

I had the accelerated Hep B vaccine in 2005 in UK (0, 1 and 3 weeks, though may have been at 4 weeks.) My titres were very low so I had a booster in 2010 (rose to >1000). I believe the level was around 800 in 2019

Today I received ORAL SEX (he performed it on my penis) from a gay male who has Hep B.

He also masturbated me at the same time as performing oral sex on me, after he had masturbated himself (he hadn't ejaculated but there was precum on his hand).

Incidentally, I'm currently on a high dose of Prednisolone (40mg per day last week, 35mg per day this week) to moderate-to-severe Ulcerative Colitis flare up, so my immune system is compromised and I am not so well. Blood CRP was 38 when tested 2 weeks ago

What do you think of the Hep B risk and any recommended interventions? Thanks

H. Hunter Handsfield, MD

18 months ago

Welcome. Thanks for your confidence in our services.

Hepatitis B virus (HBV) is rarely if ever transmitted by oral sex. Hand-genital contact, even with genital fluids as lubrication, is no risk for STIs in general; although there are no data for HBV in particular, I would consider this also to be zero risk. Even if you had never been vaccinated, I would consider this a zero risk exposure. With vaccination, it's below zero -- if that were a realistic option.

All is well. No risk at all, do not get tested. Let me know if anything isn't clear.

HHH, MD

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18 months ago

Thanks so much for your quick and informative reply.

I guess my assumption was that, since my immune system is suppressed as a result of the inflammation and the course of Prednisolone, I was at a higher risk of the virus breaching my immune system's defences, even though I have been vaccinated in the past. Is that correct?

The only other question I had is, based on the number of years since my last injection, do I need a Hep B booster injection?

Thanks again.

H. Hunter Handsfield, MD

18 months ago

Sorry I forgot to comment on your prednisolone treatment. Immunosuppression in general actually has little effect on infection susceptibility. You also are not a increased risk of catching. colds, influenza, covid, or any other. It can impair your response to these and other infection, i.e.the symptoms might be worse and complications more likely. In addition, existing infections might flare up -- think herpes, tuberculosis, and your lifelong infection with varicella zoster (the cause of chickenpox) which can lead to herpes zoster (shingles). But your treatment did not significantly raise your risk of HBV if exposed.

I hope your UC flare comes under control promptly. Good luck.

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18 months ago

Thank you very much.

Just to clarify, taking into account the prednisolone, does your initial impression (first reply) still apply regarding the risk of my exposure and not needing to test?

H. Hunter Handsfield, MD

18 months ago

Yes, it does -- isn't it obvious from all my comments?

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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