[Question #1464] Hepatitis B

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90 months ago
Hello Dr,

I had a once off sexual encounter with a woman( unknown std status and her profession has risk) , performed oral sex on her only, 7 weeks ago. I have tested for allot of other std's and they have conclusively been negative. The only test I did not do at 6 weeks after possible exposure was Hepatitis B which I then had done at just short of 7 weeks after possible exposure. 

Please advise on the following,

1. HIV once off exposure risk performing cunilingus is extremely low and there has been an percentage linked to it, is there an infection percentage for Hep-B, information online states that it is 50-100 times more infectious? 

2. In between the other test's mentioned above a testosterone test was also done (for other medical reasons) and what was found is that my SHBG was high, 63.4 nmol/L. This can be attributed to me being a smoker as well? It was mentioned to me that their should be concern if SHBG is over 80.00 nmol/L?
But this had planted a seed with me and i decided to do a Hepatitis test.

3. The test that was done (just short of 7 weeks after possible exposure) was a surface antibody test which came back negative which i have now found to be the wrong test as it only proves that I am not immune? And will have to do another test again. Which is correct test to do to determine if i am infected or not, the testing facility seems to be confused on what is the correct test to do? Was the surface anti body test a total waste of time an money or can there be some form of value to it in current circumstances?

Please advise.


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H. Hunter Handsfield, MD
90 months ago
Welcome back, but sorry to see you remain so concerned despite the reasoned, science based responses you had from Dr. Hook. For the most part these are asking the same questions again in different words, so my replies are succinct; and part of what you ask is off topic for this forum.

1) There are no such data available for hepatitis B. As Dr. Hook told you, HBV is not known to be transmitted by oral sex and your risk was zero for all practical purposes. No testing was recommended.

2) This forum deals only with STDs and we have no expertise in endocrinology or sex hormone testing. I know nothing about these test results or how to interpet them. In any case, I see no reason this should have "planted a seed" about heptitis testing.

3) You had the correct test, normally done in people to rule out hepatitis B, and to the best of my knowledge 7 weeks is plenty of time. The negative results shows both that you were not infected during the exposure 7 weeks earlier and that you are not immune due to past HBV infection or immunization.

I hope this has helped. Best wishes--  HHH, MD

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89 months ago
Hello Dr,

Please bear with me as I am extremely stressed by my current situation as one thing after another is happening and I am not getting a sense of comfort from my Dr.

I had a sonar scan done today due to pain in my right testicle, this is something i have had for quite a while before my exposure.

The sonar scan diagnosed me with epididymitis of the right testicle.

I have read up on this and the causes of epididymitis and this where my concern lies as I had test's done to rule out these diseases and I now feel as if all these tests are null and void and everything/testing has to start all over again for all diseases?

I have had prostatitis in the past and my Dr did recently, 2 weeks ago diagnose me with it again, I did not take medication for it at that time but I am starting antibiotics today.

I have to date had no discharge of any kind, only pain and burning sensation when urinating but this was also periodically present before the exposure and except for this one time I have been monogamous for 10 years and in the past 8 weeks have had no sexual contact of any kind.

For your ease of reference I am listing the tests that I have had done and at what time, this is verbatim as written on test results:

First Round Of Testing:


1. Syphilis blood test 8 days after event-negative

2. Chlamydia trachomatis pcr test 8 days after event- not detected

3. Qualitative PCR HIV  blood test performed by lab 31 days after exposure- result negative


Second Round Of Testing:

1. ELISA Gen4 blood test performed by lab 41 days after exposure- result non reactive.

2. Chlamydia blood test performed by lab 41 days after exposure- result negative (c.trachomatis lgg 13.04 ru/ml, c. trachomatis lgm 0.36 ratio)

3. Gonococcal antibodies blood test performed by lab 41 days after exposure- result negative

4. T.Pallidum Total Serum blood test performed by lab 41 days after exposure- result negative

5. Hepatitis B Surface antigen blood test 44 days after exposure - result negative.

Please your opinion will be greatly valued on the way forward.


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H. Hunter Handsfield, MD
89 months ago
It is true that gonorrhea and chlamydia can cause epididymitis. No other STDs do so. Your chlamydia test proved you don't have chlamydia and it isn't the cause of epididymitis. The gonorrhea blood test is useless; if a gonorrhea urine or urethral swab test has not been done, ask your doctor about it. However, gonorrhea almost certainly is not the cause of this problem.

You have no STD problem at this time. Therefore, this forum cannot help you further. Sorry. Good luck.