[Question #3452] Hepatitis B,C & HIV Transmission

35 months ago

I'm male and I did a vigorous fingering on a female CSW and was masturbating myself with the other hand with a condom on. That was the only sexual activity. After the episode when I went to wash my fingers ,I realized that I had menstrual blood on my index and middle finger. The Episode was about 10-12 minutes and immediately washed thoroughly after the episode with soap and hot water. With a quick investigation i noticed both the index & middle finger did not have any active , fresh wound or it was not bleeding . My concern is the cutitcles above the index and middle fingers always had little gaps and blood was filed in that part. I'm worried that since my fingering was intense , the blood could have ingested into the blood stream through the susceptible skin inside/around the cuticles. My question is the chances of HCV , HBV transmission in this episode. I took HBV first 2 shots of HBV vaccine last year and have not completed the third shot yet.

1. Assuming the CSW had Heptitis C or B infection ,Should this episode merit for HCV and HBV testing ?
2. Does the hepatitis(HCV &HBV) transmission still happen on the microscopic abrasions on the fingers and like the light peeled off or cracked skin on the fingers or it requires FRESH,DEEP and ACTIVELY bleeding wounds ?
3. Assuming the skin around my cutitles had peeled , cracked skin , would this lead to HCV , HBV and HIV transmission?
3. With my incomplete Hep B vaccine shots I took last year , would that protect me from Hep B infection from the episode I mentioned.

Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to ur Forum.  I'll be glad to comment.  the activity that you describe was a no risk event  Even with active cuts or irritated cuticles, IF YOUR PARTNER HAD HIV, HEPATITIS, OR OTHER STI - most CSWs do not), masturbation of an infected person is a no risk event and is considered safe sex.  Similarly, there is no known risk for acquisition of infection from masturbation of an infected person while they are menstruating.  This was a no risk event and does not require counseling.  In answer to your specific questions:

1. Assuming the CSW had Heptitis C or B infection ,Should this episode merit for HCV and HBV testing ?
Please see above, no need for testing.

2. Does the hepatitis(HCV &HBV) transmission still happen on the microscopic abrasions on the fingers and like the light peeled off or cracked skin on the fingers or it requires FRESH,DEEP and ACTIVELY bleeding wounds ?
Abrasions, microscopic or otherwise are not considered risk factors for hepatitis.  They are listed as such out of an abundance of caution but if such exposures lead to infection at all, it is very, very rare.

3. Assuming the skin around my cutitles had peeled , cracked skin , would this lead to HCV , HBV and HIV transmission?
No, absolutely not.

3. With my incomplete Hep B vaccine shots I took last year , would that protect me from Hep B infection from the episode I mentioned.
Yes, two injections typically provide immunity to infection.  The 3rd shot helps to consolidate that immunity.  I would however recommend that you go on and get your 3rd injection at some point in the future. 

I hope these comments are helpful.  Please don't worry about risk for STI or hepatitis from the events you describe above.  EWH
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35 months ago
Thank you so much for your response Doctor. I have little bit lengthy questions this time and please bear with me.

Previously when I tested for Hepatitis Panel on (01/15) , my results were as shown below
HCV - 0.3 ;  HBsAG - Negative ; Hep B Core  Ab, Tot - Negative

1. Assuming my recent exposure risk to be virtually Zero ,  Will the HCV Antibody be increased in my next blood tests?
2. When I'm immune to Hepatitis B which means that I won't be infected unless a high risk exposure is involved. In that case will I be able to pass the Hep B to an non infected person ?
3. In your response above , Can you please explain the context "out of an abundance of caution" ?
4. If the skins looks intact (with no visible cuts or bleeding ) , when the menstrual blood is massaged into  cuticles vigorously . Can I assume the risk is simply Zero for HCV , HBV and HIV ?
5. Should i have to touch the Genital Herpes lesion or vaginal secretions or HSV2 viral shedding to develop herpetic whitlow ?
6. In my recent exposure , Can I still develop Herpetic whitlow on my fingers even when my fingers are intact ( with no visible cuts , bleeding) ?

Prior to the recent exposure last week , I had a similar exposure on 01/19, where I had a deep healing wound on my middle finger .( 2 day old healing wound prior to the exposure on 01/19 ,But the wound was still red and could see the flesh) . During this exposure I did not touch the genitals of the escort . All I did is that I just squeezed the breasts and I vigorously  fingered her belly button with my wounded middle finger

Assuming this exposure was risk free and I involved in protected vaginal sex and performed oral sex on my girl friend on 02/07 . Exactly after a couple of weeks she developed severe cold and flu like symptoms and visited her Primary Physician . On diagnosing my girl friend ( nose and ears) she was told that she developed allergy and was on antibiotics for 10 days. Despite the antibiotics course the nasal congestion is not reduced and has only aggravated . She could barely breathe and only breaths through her mouth and never sleeps at night . I feel very guilty my anxiety level is at peak and I've got an appointment next week for my girl friend.
7) Prior to sex with my girl friend, I brushed the teeth and fear that some blood from brushing would have transmitted during my oral sex .
8) I'm wondering if I had developed HCV , HBV after the exposure on 01/19 , did I pass that on to my girl friend without my knowledge since i was not tested ?
9) My girl friend is suffering from severe nasal congestion with Dark yellowish mucus with blood stains whenever she drains her Nose , accompanied by inconsistent headache ,mild flu like symptoms and Loss of appetite ,Swollen cheeks (Sinusitis) - Is this sign of early stages of Hepatitis infection ( HCV , HBV) or STI infection ?
10) what is the STI risk involved in my oral sex with my girl friend ?


Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Straight to your extensive and somewhat repetitive questions.

1.  The HCV test will remain negative.
2.  Heatitis B vaccine prevents acquistion of hepatits B.  If you do not have hepatitis B, you cannot transmit it.
3.  They are listed because the organizations are being caution and while there are no case of transmission which have been proven to be transmitted this way, they are being cautious because, theoretically, it might happen some time.
4.  Yes
5.  Yes, direct contact is required to acquire HSV.
6.  Theoretically yes however the is extraordinarily unlikely and not a realistic concern.
7.  No question is stated here.
8.  No, your tests prove you do not have these infections, thus you cannot transmit them
9.  No
10.  Minimal.

EWH
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34 months ago
Thank you so much for detailed response , once again appreciate your service here :)
My last final question(s) ...

1) What is the window period to test for HCV ? ( Some say it is 6 month and others it is 6 weeks)
2) Can you please tell me definitive/conclusive window period for HCV ?

I had recently been to GP and on examination I was told that I've a genital Wart since the doctor was not quire sure about it and so was asked to consult a derm on this . I immediately met a dermatologist and he either could not confirm if that it is wart because it was so small and asked me to wait over a month period. The Derm is suspecting that to a hair follicle and hence the wait period .My suspected  GW is located on the bottom of the scrotum and in 2 different places at times itchy and not always. I'm not sure when I developed this and really did not notice since it was bottom of the sack.

2) If that is a wart , will that become bigger and spread over a period of month or so ?
3) How long does a wart take bigger and multiply to other parts of genitals?


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Final responses:

1&2.  Testing for hepatitis C (which is very rarely and STI) is conclusive six weeks after exposure.

3. This is an unusual place for a genital wart.  If it were a wart, it would get larger with the passage of a month.  Do not repeatedly examine or traumatize the area as this will only confuse things.

4.  Wart infections are local processes which do not spread to other parts of the genitalia or body.  When present, they may grow larger at a modest pace, over periods of weeks. 

this completes this thread. There will be no further answers and the thread will be closed in a few hours.  I urge you to put your unwarranted fears and concerns over the NO RISK event you described aside and move forward without concern.  EWH
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