[Question #12327] HCV from a toothbrush

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8 months ago
I'm so sorry doctors to bother you all again with questions about my intense fear of blood borne diseases and viruses.  I saw some silly poster today about not sharing toothbrushes and I remembered as a little girl that i used to share a electric toothbrush with my father for while.  This was about twenty years ago, he died a long time ago as did my mother so I don't know his HCV status, he never mentioned having it nor did anyone in my family.  I was tested for everything STD related (HIV, HBV, Syphilis, etc) but never for HCV - I probably used the toothbrush 20-30 times not much more than that.  I know there were times when my gums bleed, but the toothbrush was used always long after anybody else had used it, probably dry much of the time, never right after his usage.  Am I in any danger of HCV?  I read some articles on your site and one that DR EWH answered said the risk was very low or theoretical -  but more exposures the higher the risk?  Would 20-30 times or say even 100 times (doubt it was this high) would it put me at risk for contracting HCV?  Do I need to get tested over this particular situation?  Could I have gotten HCV this way - as I said I have never been tested.  Thanks in advance.
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H. Hunter Handsfield, MD
8 months ago
I'm sorry you felt the need to return with these worries. In a way, your question doesn't fit with an STD forum:  HCV is not even sexually transmitted (except between men having traumatic (i.e. potentially bloody) anal sex with other mael partners). HCV is no more common in the heterosexual partners of infected people than in anyone else, which is why HCV testing is not routine during most STD evaluations. On the other hand, of course we get many questions about it, partly because or parallels with HIV testing. But more about testing below.

Your questions are illogical on many counts. First, electric toothbrushes are designed with different brush heads for different users. But even if you used the same head as your dad, he would need to have HCV for you to be exposed. If he had HCV back then, he likely would have had liver disease by now. Has that been a problem for him? Was he an injection drug user or a gay man having anal sex with other men? Had he had major surgery or injury requiring multiple blood transfusions? If none of these risks, there is little chance he had HCV. Might you have used the brush immediately after him, while still wet with visible blood? Probably not. All in all I would guess the risk of HCV from sharing your toothbrush all those years ago would be no higher than one chance in millions, maybe under one in a billion. Maybe the same risk, roughly, as you being struck by a meteorite. Even a hundred shared toothbrushing events still would make it nearly impossible you are infected.

Do I recommend HCV testing for you? Yes and no. Definitely not on account the toothbrush business. Why yes? Because CDC and all public health authorities advise that every American have an HCV blood test once, in case of unknown or unremembered risks. In theory, that means injection drug use, male-male rectal sex, or blood transfusion in past decades (before donated blood was routinely tested). Even without such risks, still the advice is for everybody to have a test. Since it's on your mind and you're anxious about it, maybe this should be your time. But again I stress this advice has nothing to do with your toothbrush concerns.

I hope these comments help you move through these worries. Let me know if anything isn't clear.

HHH, MD
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8 months ago
My dad died many years ago - he did have a major surgery but that was after I had shared his toothbrush, we did you use the same head as he would complain to me about using it :) -  he died about ten years after the sharing of the brushes - to my knowledge he had no liver issues.  He was not gay or a drug user - so I guess that supports that he died not have HCV.  So I have a couple of follow-ups - I understand he is unlikely to have had HCV so the meteorite analogy probably holds for me correct?  If he did have HCV what might my risk be then?  Last question if I was infected it would have been 20-25 years ago would I be having liver issues now?  I do not -  all in all - I don't know his HCV status - but it seems like it would be highly unlikely for me to have HCV from this - the meteorite analogy - correct?  Thank you Dr. Handsfield.
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H. Hunter Handsfield, MD
8 months ago
I'm sorry, but I'm not going to speculate in unrealistic "what ifs". I would hold to the meteorite analogy regardless of these details. For all the reasons noted above and your intellectual understanding (if not emotional acceptance) you can safely believe you do not have HCV.---
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