[Question #11984] Follow up concerns
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11 months ago
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Hello, I made a post a week ago regarding my concerns following an encounter at the beginning of August. These concerns were considered low risk for HIV and Hep B.
I am now a little over 6 weeks post encounter, and my remaining symptoms are a persistent sore throat, which is uncomfortable when swallowing, a sore mouth (slight burning sensation), dulled tastebuds and ulcers below my tongue. I also have abdominal pain which has got worse the last few days and I constantly feel bloated. Stomach makes frequent gurgling noises too, and this has been the case for 2-3 weeks now. Also still peeing more frequently than normal and my limbs feel slightly achey, mostly my knees and upper arms - but this is only occasional. I know Dr Handsfield believed my encounter to carry little risk for HIV and Hep B. I’m slightly less concerned about the former now, because I tested negative for it on day 10, 24 and 32 and the female in question, on day 25. However, the Hep B concerns remain - especially as I haven’t been vaccinated and I’m unclear if she has. I have a couple of questions. 1) Dr Handsfield advised that he has not come across heterosexual Hep B transmission during his many years in the STD business, but when I look online there’s information about how infectious it is, and how it is ‘readily’ transmitted during vaginal sex. Can this be clarified at all? 2) In addition to the unprotected vaginal sex, we also deep kissed for quite a while prior to vaginal sex. The kissing happened on more than one occasion over the course of a couple of days or so. I don’t believe either of us had any sores in our mouth, but then it’s not necessarily something that you would definitely notice? Sorry to revisit this, but I welcome the oportunity to speak with the experts here again.
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Edward W. Hook M.D.
11 months ago
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Welcome back to the Forum. I'm sorry to hear that your symptoms have persisted and that you continue to worry about hepatis B. In preparing to respond I read your interaction with Dr. Handsfield from last week and agree with all that he said.
The primary symptoms of hepatitis B are abdominal tenderness in the right upper quadrant of the abdomen, just under the rib cage. Symptoms such as frequent urination, bloating, and an active stomach are NOT typical hepatitis symptoms (urinary frequency is not a sign of STI either- it is most strongly associated with anxiety)
Before vaccination became widespread. most hepatitis B was transmitted sexually. The vaccine has made that uncommon. Even if you had sex with a person with active hepatitis B (most persons who have hepatitis get over it after a few weeks with no lingering effects), only a very small proportion (there are no good estimates, probably less than 10%) become infected.
As Dr. Handsfield said, considering that it is unlikely that your partner had active hepatitis B and even more unlikely that you acquired it, I would be very surprised if you had acquired it. You are now a month out from your single unprotected exposure. If you wish to prove that you were not infected and that your symptoms are not due to hepatitis B, get tested. When the result is negative as I am confident it will be, you will have ruled out any possibility that you acquired hepatitis from your casual exposure.
I can tell you categorically that hepatitis B is NOT transmitted by kissing, even with deep kissing and exchange of saliva.
Finally, please stay off the internet which I suspect is where to acquired the misinformation that sexually acquired hepatitis B is common and/or easily transmitted. It is not.
I hope that this information is helpful. Please don't worry. EWH
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11 months ago
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Thank you for your response Dr Hook. Both yourself and Dr. I did enquire with my local sexual health clinic today (UK), but they seemed reluctant to test me for Hep B, as they don’t consider my exposure to be a risk. I certainly don’t want to waste finite resource, but I’m still a little surprised. They went as far to say I can’t contract it from a female. I don’t believe that’s correct, but is it really so rare and I’m worrying over nothing? Have you and Dr Handsfield come across so few instances of heterosexual transmission?
In regards to my urinary symptoms, water was definitely passing straight through me initially. I would drink a glass of water and have to go to the toilet straightaway. I do think something upset my prostrate (as this was accompanied by testicular, pelvic and back pain for about two weeks) - all of which has mostly subsided now. About 4/5 years ago, I did have an issue with my prostrate which forced me to go to urgent care. There was no obvious reason for it, but antibiotics did seem to resolve the issue (night sweats, extreme pain in the area). I appreciate that, that’s another issue though.
Thanks again.
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Edward W. Hook M.D.
11 months ago
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As I have tried to indicate in my comments above, and as Dr. Handsfield indicated before me, your risk for acquiring hepatitis B through the exposure, you describe is minuscule and not something that I would be worried about. Thus I cannot fault the clinician you saw in declining to you for hepatitis B.
As you skitter from one concern to another, I have to say that the symptoms of urinary frequency that you describe are not symptoms of any STI.
I believe the information provided in this post largely verifies, which you’ve already been told by Dr. Handsfield, by myself, and by the clinician you saw. I’m hopeful that this consensus by clinicians will allow you to move forward without continuing concern. EWH.
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11 months ago
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Thank you kindly Dr Hook.
My final question. I managed to instead get a finger-prick serum antibody test. My sample was reviewed by an NHS accredited lab, rather than the in-vein test I would have preferred. It has come back as no sign of previous infection nor immunity ( I do plan to get vaccinated shortly). The sample was taken on day 42 post exposure. I assume this is too soon for it to be in anyway accurate?
I’ve read that antigen test can be conclusive at 28 days, which I may arrange privately so I can move on. Is this time frame correct? I also plan to test for H Pylori - which I know isn’t considered a STD. Thanks again.
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11 months ago
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My partner also tested negative for Heb B with the same finger-prick serum test I took (that was then reviewed by a lab). We haven’t slept together since the beginning of August. So it’s the same time frame as me. It’s only me that still has any symptoms - my partner doesn’t and neither does the girl I had was unfaithful with.
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Edward W. Hook M.D.
11 months ago
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Final response
42 days following an encounter, if you had acquired hepatitis B, I would anticipate that a hepatitis B antibody test of the sort you describe would be positive. This is strong evidence that you (and your partner) do not have hepatitis B.
I would encourage you to now do two things. First and foremost, put your unfounded concerns about hepatitis B aside and move forward. Secondly, to avoid further concerns I would encourage you to get vaccinated for hepatitis B.
As you know, this is my third and therefore response. This thread will now be closed. Take care. Please don’t worry. EWH.
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