[Question #12828] HIV, HEP B, HEP C and Tattoo #2 (Dr. Handsfield)

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4 months ago
Sorry for coming back, but this will be the final summary.

From our previous conversation, I contacted AIDS Access Foundation and asked them about traditional Thai tattooing. They told me that there is no risk of HIV and Hepatitis B and C, even if the needles are not changed, because the needles used for tattooing are different from syringe needles, and Hepatitis B, C, and HIV are very fragile. I would like to know if you agree with them or not ? because I found information on the internet stating that Hepatitis B and C viruses can survive outside the body for several weeks, which contradicts what they told me about these viruses being fragile.
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Edward W. Hook M.D.
4 months ago
Welcome back to the Forum.  On this occasion I will be responding to your follow-up questions.  Like Dr. Handsfield I am not familiar with traditional Thai tattooing.  I have searched the medical literature and found a number of reports of bacterial infections occurring related to Thai tattooing, some quite severe but no medical literature on viral infections such as HIV or hepatitis viruses.  That does not mean that they do not occur and I would think that there is at least a theoretical possibility of such infections occurring.  The fact that the same needle (apparently often bamboo) and ink pot are known certainly introduces the possibility of infection transmission.  Things that might have some effect on the risk of infection would include what sort of liquids might be used in the tattoo ink (for instance alcohol would reduce risk), how the needles are cleaned between clients, the time intervals between clients (the longer the interval the more likely that viruses or bacteria would be non-infectious), and any steps used to sterilize or clean the needles.  

HIV and other viruses do become less infectious with exposure to the environment (temperature, drying, etc.) rather quickly.

In summary, again, while there are no reports of hepatitis or HIV acquistion that I found related to traditional Thai tattooing, there is no doubt that this is a theoretical possibility.  The steps and procedures used by the tattoo artist would also effect the risk for infection.  You would need to discuss with with the tattooist.  

That's about all I can say.  To say there is no risk seems wrong.  EWH
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4 months ago
Thank you for the answer. Is there a difference between theoretical risk and actual risk ? In that event, I got a tattoo about half an hour after the person before me. What diseases should I check for ? (HIV or HBV or HCV ?) and How many weeks after the risk exposure can the test results be conclusive sir ?
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Edward W. Hook M.D.
4 months ago
The word theoretical means that it can occur but has not yet been described. The risk is likely to be low not zero.  If I were you and were concerned I would seek testing for HIV and hepatitis B and C.  The hepatitis B testing should be a hepatitis B screen which includes both testing for Hepatitis B antigen as well as antibodies to the virus.  Results of such testing will be conclusive 6 weeks after the event.  

You have one follow-up remaining.  After that the thread will be closed and you should not need to return until there are test results to discuss, at the earliest.  EWH
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4 months ago
I never thought it would be this scary. I'm really scared, especially about HIV. I should probably get tested after 6 weeks, and the results for Hepatitis C can also be confirmed after 6 weeks, right?

Lastly, I would like to thank everyone who has been answering my questions, even though it may not be directly related to this website. I truly appreciate it.
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Edward W. Hook M.D.
4 months ago
To be honest, the overall risk of infection is relatively low. Having said that, however, given your anxiety, I agree that testing would be a good idea. Testing at six weeks for each of the viruses I have mentioned including hepatitis C will be conclusive. I anticipate that the tests will be negative.

As you know with this final response, this thread will not be closed. I wish you the best. Take care. EWH.
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