[Question #4071] Hep B/Hep C/Bloodborne - advice still holds?

33 months ago
Hello Drs,

First of all I just wanted to say how great/informative this site is, I have found your responses posted on here most helpful. This is probably easy/obvious question but would like please just to confirm. 

I was reading previous responses, specifically #1543, #2653 and #3108. Basically in summary your responses to questions on infection risk were:

-The risk of transmission for HBV/HCV/HIV living with an infected person for 3 months or less and sharing razors/toothbrush/towels/other household objects, would be <1% (with no-one being vaccinated)

- There are no known illnesses/conditions/medications which would increase substantially the risk of a person being infected through the above-mentioned transmission

- The above also applies to any other STDs (i.e. <1% risk of transmission)

I just ask because this is relevant to my situation (me and my former girlfriend were living with my parents and my 18-year old sister for 2 months - my former girlfriend was high-risk for HBV etc). We live in western country but none of us are vaccinated against HBV.

So my question is - am I correct to assume there has been no new developments/understanding in the medical community that would change your previous advice? This is not based on anything but just my own fear of relying on out-of-date information. I would think all your previous advice holds, but just wanted to check as the responses were from some months ago (i.e. in 2016 and 2017)

Thank you very much in advance Drs

33 months ago
Sorry to add, this was partly prompted by looking at travel vaccination advice online, agencies such as CDC/WHO/ISTM all advise to have HBV vaccination before visiting certain countries. So I wanted to check this was just these agencies taking a safe/conservative approach and is not anything new/recent they are now saying. 

So my question is just to check I am correct to assume there has been no new developments/understanding in the medical community, to change the above advice? I.e. check it is still up to date? (on risk of transmission to my parents, and 18-year old sister)
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Welcome to our Forum and thanks for your confidence.  We try to provide science-based responses to the questions we receive.  I'll do my best to do the same for you. 

-The risk of transmission for HBV/HCV/HIV living with an infected person for 3 months or less and sharing razors/toothbrush/towels/other household objects, would be <1% (with no-one being vaccinated).
Correct.  While sharing razors and toothbrshes are in "the list" of theoretical mechanisms of HIV and hepatitis transmission, the fact is that he risk for acquiring infection in this way is exceedingly low.  Nonetheless, best not to share such hygiene devices. 

- There are no known illnesses/conditions/medications which would increase substantially the risk of a person being infected through the above-mentioned transmission
Correct as well.

- The above also applies to any other STDs (i.e. <1% risk of transmission)
Correct.  In fact the risk for transmission/acquisition of other STIs through the sorts of exposures you describe is far lower than for HBV.HCV/HIV

Please remember as well that your former GF may be at risk for HBV but that does not by any means she has it. 

Yes, or previous advice still holds.  No change in our advice.  EWH
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33 months ago
Dr Hook,

Thank you so much that is extremely helpful. I think I know the answers to these follow-ups but just would like to confirm:

When yourself and Dr. Handsfield state there are no known illnesses/medication to materially increase risk of transmission of bloodborne/STDs, this would also include uncommon conditions such as Immune Thrombocytopenic Purpura (IPT) / Idiopathic Thrombocytopenic Purpura? I.e. even if someone were to have this condition, their overall risk of contracting HBV/HCV/HIV/any other STDs from sharing razors/toothbrush/towels/household objects would still be <1%, over a 3 month period?

- I mentioned my sister was 18 years old at the time my former gf was living with us - presumably the age of an adult is not relevant/would not materially change their risk of contracting HBV/HCV/HIV/any other STDs?

Many thanks again Dr Hook 






Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Clearly you are concerned about this but nothing in your follow up "what if" questions is associated with increased risk.  If there were qualifications to my "no risk" assessment, I would have provided them.  EWH
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33 months ago

Thank you again Dr that’s so very helpful. One thing I didn’t mention is my ex-girlfriend was a massage therapist, so would occasionally give my parents and sister massages (non-sexual). Am I right to assume normal (ie non-sexual) massages doesn’t change any of yours and Dr Handsfield’s previous advice?


And am I right in taking Dr Handsfield’s advice as that there are no known conditions/medications that a person can have to materially increase their risk of contracting HBV/HCV/HIV and other STDs, via any bloodborne/non-sexual route? (ie not just the shared hygiene objects mentioned above)


Below were conditions I saw being mentioned to Dr. Handsfield in previous response I found (a lot apply to my family, as collectively they have a number of conditions).

I’m right in saying none of these would materially increase the risk of contracting HBV/HCV/HIV and other STDs, via any bloodborne/non-sexual route?


  • Immune thrombocytopenic purpura (ITP)
  • Bronchiectasis/COPD/asthma/bronchitis/respiratory 
  • High-dose long term oral steroid use for Bronchiectasis/COPD/asthma/bronchitis
  • Von Willebrand / other blood clotting disorders
  • Varicose veins 
  • Diabetes


Sorry if this is repetitive, just want to check I understand all correctly

Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Your follow-up question is a bit repetitive.  It seems like at least part of your questions are looking for general answers. The purpose of our Forum is to provide individualized responses and guidance for specific questions and situations.  As this is my final response to your questions, I must also point out that we have a prohibition on repetitive, anxiety-driven questions which your thread is evolving towards.  If new posts are judged to be in this realm, they may be deleted without a refund of your posting fee and without a detailed answer.

As for your follow-up questions:
A masseuse or massage therapist who is not involved in mucosal exchange of secretions (sex) is not at risk for STI, including HIV and hepatitis viruses.  No change in our advice or opinions.

" there are no known conditions/medications that a person can have to materially increase their risk of contracting HBV/HCV/HIV and other STDs, via any bloodborne/non-sexual route? (ie not just the shared hygiene objects mentioned above)"
Correct

"Immune thrombocytopenic purpura

there are no known conditions/medications that a person can have to materially increase their risk of contracting HBV/HCV/HIV and other STDs, via any bloodborne/non-sexual route? (ie not just the shared hygiene objects mentioned above)"
Correct

"Immune thrombocytopenic purpura (ITP)
  • Bronchiectasis/COPD/asthma/bronchitis/respiratory 
  • High-dose long term oral steroid use for Bronchiectasis/COPD/asthma/bronchitis
  • Von Willebrand / other blood clotting disorders
  • Varicose veins 
  • Diabetes"
  • For the 3rd and final time- no risk.
  • This thread is now over and will be closed later today without further responses.  EWH

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