[Question #153] STD and Hepatitis B Risk

37 months ago
Hello Doctors,

I've done a little searching online, but I'm sure you know that can be a warren of conflicting information.  I have what I hope is a simple question:  I had an encounter with a sex worker a few days ago.  I always limit myself to safer activities (kissing and mutual masturbation only) when I do this kind of thing.  I noticed while I was getting a hand job the sex worker used her saliva as a lubricant spitting directly on my penis.  It seems clear to me even with all the information online that I was not at risk for HIV, but since Hep B is found in saliva could I have gotten infected this way?  Everything I read seems to indicate I was at a kind of theoretical risk for herpes but pretty much nothing else.  So the Hep B question is giving me some anxiety.  Any illumination would be helpful.  Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Welcome to our Forum.  I will try to help.  The fact that scientific studies using ultrasensitive detections methods can detect the presence of STI pathogens such as HIV, herpes viruses or other organisms does not mean that transfer of saliva is a meaningful way for infections to be transmitted from person to person.  In fact, there are no well documented cases in which HIV or hepatitis B have been transferred to another person either through performance or oral sex on an uninfected partner or through transfer of saliva from person to person (through spitting, kissing, etc.)  Similarly, while herpes is a bit more difficult to make equally strong statements about herpes transmission (in part because the disease is so common), as you point out, suggestions that HSV can be transmitted through transfer of saliva from and infected to a non-infected person are also theoretical.   The activities you describe are safe sex.  There is no reason for concern and no reason to seek testing.  I hope this information is reassuring.  EWH
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37 months ago
Hi Docter Hook.  Thank you very much for the reassuring reply.  I get it.  However, since I'm allowed a follow up, may I ask a further question?  I had some kind of hepatitis around 15 years ago.  I don't remember the letter (A,B, etc.), but I recall my doctor telling me it was likely from food and not a sexual encounter.  I had terrible flu-like symptoms, the tea colored urine and the hole 9 yards. If I were to get tested now, would that older infection contaminate the results today?  And in general what is the accepted testing window for Hepatitis?  In the wake of your answer, I likely will not get tested, I'm just curious for future reference.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago

What you do describe does sound like hepatitis and the most common food born hepatitis is hepatitis A.  that may have been what you had.  With regard to testing windows, if a person acquired hepatitis, they typically develop antibody evidence of infection within two months of acquisition.

If you are concerned about hepatitis, my advice would be to ask your health care provider to perform antibody tests for hepatitis A, B, and C (one test- a "hepatitis screen").  If you have not had hepatitis a or B, and are not yet vaccinated, you should consider this- the vaccines are widely available and highly effective.  EWH

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37 months ago
Hi Dr. Hook - thank you again.  With so much conflicting information out there, this service from ASHA is truly invaluable.  This is my last follow up, so a few questions -

1. Based on your initial response, there is no need for testing as hepatitis isn't transmitted via saliva this way, correct?  Your website here does confirm this and says that the rare cases of saliva transmitting the disease is from a bite.
2. It was really just information for the future - but what I was asking was would my previous Hepatitis A infection contaminate the results of the Hep panel you're talking about?  What I mean is  would the Hep B wouldn't show up as positive now because I had Hep A years ago?
3. Does the vaccine clear current infections or just protect against future ones?

Thanks again, Dr. Hook.  You've made it possible for me to sleep at night.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago

Final responses:

1. Correct.

2. If you had hepatitis A in the past it would show up in a screen for hepatitis antibodies but it would not obscure information about whether or not you had acquired hepatitis B or C.

3. Vaccines are not therapeutic at this time but would prevent/reduce risk of future infection.

Hope this helps.  Take care. The thread will now be closed.  EWH

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