[Question #3237] Modes Of Transmission - HIV, HEP B, HEP C & Herpes 1 &2?

39 months ago

Hello Dr,

Please be so kind as to answer the following questions please,

It is my understanding that Hep B is allot more infectious than HIV & Hep C and that it has been found in bodily fluids like sweat etc.

I have the following questions that I would like answered please,

1. Can hep b be transmitted if one is to come into contact with bodily fluids like saliva, sweat etc through modes like skin contact(sweat), saliva through kissing or droplet of saliva in mouth( Don't use each others tooth brushes), or must it be in a purely sexual intercourse or blood to blood, open wound fashion? I have read that the virus can survive out of the body for a while, so is  shaking hands or touching surfaces hep b positive person has touched or bled( I work on construction sites and injuries happen all the time, not talking about pool of blood i mean blood from cuts on hands and leaving smudges behind etc)  and then touching mouth or rubbing eyes?

2. Hep C same as above please?

3. Hiv same as above please?

4. If one has a wound(big or small) that has formed scab be it recently or old does it offer sufficient protection if a hep b, c or hiv positive person was to touch it or if above mentioned scenarios happen?

5. My wife goes for skin treatments and from time to time she has pimples that get ruptured during the treatment while therapist is touching her is this a mode for transmission?

6. According to the antibody test I had done I am Herpes 1 & 2 negative, i know the test is only 70% accurate but let's assume I am negative, we are assuming my wife is herpes 1 positive as she has had fever blisters on her mouth before, in the 10 years that we have been married we have been kissing and practicing oral sex and I have not gotten herpes 1 from her yet based on the blood test and the fact I have not had a fever blister in the 10 years we have been together on my mouth or genitals. What is the mode of transmission for Herpes 1 & 2? Can I still get it?

Thank You in advance!

Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago

I am not sure if these question relate to your recent exposure to a waiter's saliva or more direct sexual contact. I will try to answer them but please realize that "what if", hypothetical questions about infectious disease transmission are not very precise or helpful and all too often just tend to worry people.  You are correct that hepatitis B is sexually transmissible and, when compared to HIV appears to be more infectious that HIV.  Hepatitis C sexual transmission however is extraordinarily rare and occurs almost only with receptive rectal intercourse and in those cases is still very rare.  With that, I will address your current questions:

 

1.       Can hep b be transmitted if one is to come into contact with bodily fluids like saliva, sweat etc through modes like skin contact(sweat), saliva through kissing or droplet of saliva in mouth( Don't use each others tooth brushes), or must it be in a purely sexual intercourse or blood to blood, open wound fashion? I have read that the virus can survive out of the body for a while, so is  shaking hands or touching surfaces hep b positive person has touched or bled( I work on construction sites and injuries happen all the time, not talking about pool of blood i mean blood from cuts on hands and leaving smudges behind etc)  and then touching mouth or rubbing eyes?

 

Detection of the virus in oral secretions and other sites is not the same as transmission.  There is no evidence that hepatitis B is transmitted by contact with saliva, sweat or non-genital body secretions.  In fact, oral or non-genital sexual transmission is not even mentioned in the hepatitis B literature.    Similarly, touching an wound/cut or scrape or shaking hands with a person who has hepatitis B is not a known mechanism of transmission.

 

2.       Hep C same as above please?

See my earlier comment 1 as well as my comment about Hepatitis C transmission.  For all practical purposes, at present hepatitis C is transmitted only though injection of blood deep into tissue.

 

3.       Hiv same as above please?

This is a repetitive question which was answered in part in your earlier interaction with me.  HIV in not spread in saliva, sweat, by touching, or by kissing.  It is not spread by touching inanimate objects contaminated with HIV-infected secretions or blood

 

4.       If one has a wound(big or small) that has formed scab be it recently or old does it offer sufficient protection if a hep b, c or hiv positive person was to touch it or if above mentioned scenarios happen?

See comments above.  Touching these sorts of wounds or scabs does not represent a risk for acquisition of hepatitis b, or C or HIV

 

5.       My wife goes for skin treatments and from time to time she has pimples that get ruptured during the treatment while therapist is touching her is this a mode for transmission?

This is a not risk event.

 

6.       According to the antibody test I had done I am Herpes 1& 2 negative, i know the test is only 70% accurate but let's assume I am negative, we are assuming my wife is herpes 1 positive as she has had fever blisters on her mouth before, in the 10 years that we have been married we have been kissing and practicing oral sex and I have not gotten herpes 1 from her yet based on the blood test and the fact I have not had a fever blister in the 10 years we have been together on my mouth or genitals. What is the mode of transmission for Herpes 1 & 2? Can I still get it?

Yes there is still a small risk of you acquiring HSV-1 through kissing or receipt of oral sex.  However, the infectiousness of HSV-1 tends to diminish over time.  In addition, if fever blisters/cold sores are not present, the risk of transmission is low, estimated to be in the neighborhood of less than 1 transmission per 10,000 exposures. 

 

EWH


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39 months ago
Thank you Dr! I am from South-Africa and it is estimated that at least 25% of the population is HIV positive not even talking about other diseases like Hep B etc therefore my vigilance...  Does this in anyway change your assessments on this thread or previous thread?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
No, that the prevalence of HIV, as well as many other STIs is high in south Africa in no way changes my earlier assessments for you, nor my advice.  EWH
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39 months ago
Thank you Dr! There seems to be still conflicting information on when to test for what and it appears that here we follow WHO guidelines and not CDC guidelines in your opinion when is the right time to test after an exposure HIV, Hep B &C? We do have 4th gen hiv testing here.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
I'm disappointed that you continue to worry about hepatitis infections.  Unless you have participated in receptive rectal intercourse virtually the only way to acquire hepatitis C is through injection of infectious material deep into tissue. 

There are varying estimates of when testing is most appropriate and when tests for both hepatitis B and C will detect all infections - to call this "conflicting" is an overstatement.  Part if this depends on the test used as well.   For hepatitis B, a typical hepatitis B test panel includes tests for hepatitis B surface antigen, hepatitis B core antibody and hepatitis B surface antibody.   Hepatitis B antigen is detectable in blood within two weeks of exposure and virtually all infections will be detected with a hepatitis B panel by 9-12 weeks after exposure.  Most experts agree however that persons exposed to known hepatitis B should be confident if they have a negative hepatitis B panel at 6 weeks following exposure.

For hepatitis C, again, tests vary as does the timing of test positivity.  Hepatitis C nucleic acids can typically be detected by PCR in blood  by 2 weeks after infection.  Hepatitis B testing which included antibodies is typically positive from 6-9 weeks after exposure and certainly persons who have negative tests 8-9 weeks after exposure should be confident that they were not infected.

This is my 3rd response to your questions.  My sense is that despite our efforts to provide information to relieve your anxiety over infections, you continue to worry.  I must remind you that anxiety-driven questions are not permitted on the Forum and that future anxiety-driven questions may be deleted without comment and without return of your posting fee, 

This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties, when the real answer normally should be professional counseling; and because such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand. 


This thread will be closed in a few hours.  EWH


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39 months ago
Thank you for your reply I am not asking these questions based on previous correspondence I am asking for future use if ever needed. Please comment on the HIV testing period.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
HIV tests with combination HIV antigen/HIV antibody tests provide conclusive results at 6 weeks (42-45 days) after exposure.

The thread is now closed.  Future posts on the topic of testing windows will be delete without comment. EWH
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