[Question #11402] Hep b

14 months ago

I received protected oral sex from a trans woman who was to my knowledge HIV positive. About 10 to 12 hours before I received oral I shaved my genitalia and cut myself with the razor. I really can’t remember much from the the actual act but it did not last long. About 2 weeks later I was told by a friend that the other person was hiv positive. So I got a 10 panel test at 40 days post exposure. Everything was negative. From reading other questions, I know that 40 days is close to conclusive. So I grappled with that and took multiple negative oraquick tests 6-7 months post exposure. What I am now worried about is Hepatitis B. I was negative at 40 days with the 3 tests that labcorp does but now im worried I may have that. Looking at the results it says that I am not vaccinated which really made me uneasy. I guess my question is… is my 40 day negative Hep b test good? This had been the worst 6 months ever and I thought I got over the hump but I have this last thing and I can’t find any info on it. Also I found out that the person who gave me head was on medication for HIV so maybe they also were treated for hep weather that it being vaccinated or whatever. I am not in contact with this person anymore. Thank you guys for all the work you put in on this website. If this wasn’t a thing people like me would be on doctor google for sure. Thanks again!

H. Hunter Handsfield, MD

14 months ago

Welcome. Thank you for your confidence and your kind words about our services.

I'm glad for your HIV test results, even though you were at little if any risk: there has never been a proved case of HIV transmission oral to penis and you weren't likely to be the first. And with condom protection there was also no risk for other STDs, including hepatitis B virus (HBV). While I understand your concern about HIV when you learned your partner is infected, I would have advised against testing for anything else. And by the way, HBV also is not known to be transmitted by oral sex: nobody can say the unprotected risk is zero, but certainly there was no chance given the condom use. Finally, the shaving cut doesn't make any difference: there's never been a reported case of HIV, HBV infection, or any other STD that appeared to be related to exposure of a skin cut, especially to saliva.

So I'm sorry you've had "the worst 6 months ever" -- but I'm almost more sorry you didn't see a knowledgeable expert who would have reassured you that you weren't at risk. Having said all that, I too am glad you're here and not looking for "Doctor Google"!

My final comments it that if you're under age 30 and were raised in the US, western Europe or at least someplace where HBV immunization is the norm, you do what you can to learn your childhood vaccination history. If it didn't include HBV vaccine or you can't find out, you should seek vaccination now -- and be free of future worries about it in event you have other potentially risky sexual exposures.

I hope this reply has been helpful. Let me know if anything isn't clear.

HHH, MD

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14 months ago

Thank you for that reassurance I really appreciate it. I guess I have a couple of questions to just put an end to this. Since my labcorp tests were negative for hep b and the test says that it had no evidence of immunity. Does that mean that im definitely not immune or is there still a chance I am and I should research? Second 40 days or 5.5 weeks tests for hep b ok? Lastly why would a shaving cut not change the risk factor because that was my main cause of concern. Thank you again for your services!

14 months ago

Sorry. lastly, I got routine blood work done around 3 months after the act and one of the groups of tests was a “comprehensive metabolic panel” from quest diagnostics. All my levels were in normal range including a AST and ALT test. My ALT was 16 and AST was 18 U/L. I guess my question with that is. If I were to have hep would my levels be abnormal especially around 3 months? Sorry for writing so much just wanted to get everything out on one post! Thank AGAIN haha!

H. Hunter Handsfield, MD

14 months ago

Thanks for the follow-up information and for your thanks!

Your negative HBV test results indicate you have not been vaccinated and are susceptible to hepatitis B if exposed. And those results plus your normal liver function tests indicate you do not currently have hepatitis B or any other kind of hepatitis. As noted above, you were not at risk for HBV from the exposure described and there is no point in further testing at 3 months or any other time. However, if you would like to be protected in event of real risks -- vaginal or anal sex with a partner at high risk and not vaccinated theirself -- you could be vaccinated.

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