[Question #4371] Blood clotting - STD/Bloodborne risk

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82 months ago
Hello Dr Hook/Dr. Handsfield,

I've read before on here and other forums that living with someone infected with a bloodborne disease such as HIV/Hep B/Hep C/HTLV or Syphillis, and sharing razors/toothbrush/towels/bedsheets and other household objects would not be a risk to be concerned about, over a relatively short period (several months). And also that this would apply to any other STDs. I got a lot of comfort from that - I was in a position where one of my housemates was from a high-risk country and a drug user, and on a number of occasions she shared my toothbrush/razors/towels. Also she gave me a non-sexual massage one time. We were not sexually involved however.

I was anxiously googling the other day and came across this article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925012/pdf/2046-4053-3-11.pdf  It's actually about HSV8, but what worried me was they specifically mention hemophilia as a risk factor for HIV/bloodborne. I don't have hemophilia but suffer from another blood clotting disorder (like Von Willebrand). So can I ask:

1. Do I have to worry about this? Or am I fine to assume this doesn't change your previous advice I've read on this forum and Medhelp that having a clotting disorder (like Von Willebrand and other clotting disorders) would not materially increase the risk of contracting bloodborne (HIV/Hep B/Hep C/HTLV or Syphillis) from sharing razors/towels/toothbrush/bedding/other household objects over a roughly 3 month period? Or having a non-sexual massage?

2. Would the above answer to #1 also apply to any other STDs?

Thanks Drs, really hope you can put this scared guy's mind at ease!


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Edward W. Hook M.D.
82 months ago
Welcome back to the Forum.  I'll try to help.  Google and the internet in general is not your friend here- rather it is misleading you.  Hemophilia is a risk factor for HHV-8, like HIV WAS associated with these conditions because these are blood borne infections which were transmitted to persons with hemophilia through blood transfusion.  Thus it is not the clotting disorder which used to put hemophiliacs for HIV (or HHV-8) but the increased frequency of blood transfusions and blood factors which these persons receive.  In the U.S. blood and blood products have been screened for HIV for over 30 years and the blood supply is safe.   This the answers to your questions are:

1.  No change in our advice or recommendations. This is just not something to worry about.
2.  Correct, no risk for other blood borne STIs either.  You'll be fine.

Hope this helps.  Take care.  EWH
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82 months ago
Thanks Dr. Hook, makes complete sense.

Whilst on the subject of HSV8, would you know if this is a risk for me?
The roommate I was sharing with was from a high-prevalence country (in Africa) - I know almost all HSV8 cases do not result in cancer (Kaposi Sarcoma) if the person does not have HIV, however I’m also severely asthmatic and take medication like oral steroids (for bronchitis/broncheactisis).

I’ve been tested for HIV previously and was negative, so assuming I’m HIV-negative would there be much risk of HSV8 - and if so would any other medical conditions or medication aside from HIV increase the chances of Kaposi Sarcoma developing? Or are my chances of developing cancer still very low?

Sorry Dr I realise this probably sounds improbable, as you say the internet searches were not constructive, so I’d rather check with you here than search elsewhere myself!
 



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82 months ago
Sorry by HSV8 I mean HHV-8
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82 months ago
Hi Dr, sorry realised I've rambled somewhat, so in summary here are my follow-up questions more succinctly:

1. When you say "Correct, no risk for other blood borne STIs either" - that also applies for non-bloodborne STIs, e.g. HSV 1&2 (and any other type of HSV)/chlamydia etc?

2. For HHV-8, would the overall risk of transmission via razors/towels/toothbrush/bedding/other household objects (or getting non-sexual massage) from my housemate over 3 months be low - could you give a conservative probability? Given I have blood clotting disorder and also suffer from severe asthma (take oral steroids for bronchitis/bronchiectasis/COPD) - would there be any medical conditions/medication I have that could increase the risk of transmission to me?

3. I read only a very small percentage of non-HIV positive people with HHV-8 ultimately get Kaposi Sarcoma/cancer. If I did have HHV-8 but was HIV-negative (I've been tested a while back) - do I have anything to worry about from a risk standpoint? Are there any other medical conditions aside from HIV that can increase the risk of HHV-8 ultimately turning into Kaposi Sarcoma, including the conditions I have, as described in #2?

Thankyou Dr - as you say the internet searches were not constructive, so I’d rather check with you here than search elsewhere myself!
 

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Edward W. Hook M.D.
82 months ago
I think you are worrying entirely too much.  The infections we are discussing are SEXUALLY transmitted.  Non-sexual transmission is extraordinarily rare and not something to worry about.  Clotting disorders, steroid medications, etc. do not change this.  Thus:

1.  See my comment above.  Similarly, worrying about a roommate has no basis in fact and is not a concern unless you are having sex with that person.
2.  No
3.  No

EWH
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82 months ago
Hi again Dr,

Sorry for the follow-up but I had a couple more questions:

1. I was searching through this site the other day and came across your previous mention of fish foot spas, this is something I did on 3 occasions when travelling abroad previously. I won’t be using them again, but wanted to ask:

a) I’m right that there have been no confirmed cases of HIV/Hep B/Hep C/syphillis/HTLV/HHV-8/any other STDs transmission via foot spas? So I have nothing to worry about from a risk perspective - the odds would be tens of thousands to one if not greater?

b) Von Willebrand or any other blood clotting disorders would not change this? What about severe asthma and respiratory conditions like bronchiectasis/COPD/bronchitis, and associated medications like inhaled or oral steroids? Just worried I might be at risk

c)  In the fish spas I used your feet and almost your entire legs were fully submerged in the water - would this change any of your advice in a) and b)?

2. On HHV-8 specifically, I’m right in assuming when you said there’s no risk in your previous replies above (from 2 weeks ago), the odds of transmission in all the various scenarios were >1,000 to one? 

3. I understand that HHV-8 is not your primary focus given its rarity, however I assume I can rely on all your responses as expert opinion? (sorry silly question I know)

Thank you again Dr

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82 months ago
Sorry Dr forgot to mention the 3 occasions I used fish spas were in Asia, ie areas with higher prevalence for various bloodborne diseases/STDs.
So just wanted to make that clear before you answer the above questions. Many thanks again
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82 months ago
Hi Dr, sorry just wanted to check you saw my follow-up yesterday? (appreciate you must always be very busy). I've re-posted here below for your convenience - thanks so much again Dr.

1. I was searching through this site the other day and came across your previous mention of fish foot spas, this is something I did on 3 occasions when travelling in Asia/Africa previously. I won’t be using them again, but wanted to ask:

a) I’m right that there have been no confirmed cases of HIV/Hep B/Hep C/syphillis/HTLV/HHV-8/any other STDs transmission via foot spas? So I have nothing to worry about from a risk perspective of using these in Asia/Africa - the odds would be tens of thousands to one if not greater?

b) Von Willebrand or any other blood clotting disorders would not increase the risk materially? What about severe asthma and respiratory conditions like bronchiectasis/COPD/bronchitis, and associated medications like inhaled or oral steroids - would they increase the risk materially? 

c)  In the fish spas I used my feet and almost my entire legs were fully submerged in the water - would this change any of your advice in a) and b)?

d) Also at the same time I put my hands into the fish spa water for the fish to clean, would this change your advice in a) and b)?

2. On HHV-8 specifically, I’m right in assuming when you said there’s no risk in your previous replies above (from 2 weeks ago), the odds of transmission in all the various scenarios were >1,000 to one? 

3. I understand that HHV-8 is not your primary focus given its rarity, however I assume I can rely on all your responses as expert opinion? (sorry silly question I know)

Thank you again so much Dr

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Edward W. Hook M.D.
82 months ago
Your repetitive anxiety-driven questions do not change my answers.  As per Forum guidelines, this will be my final response to your questions and further, repetitive posts may not be answered without a refund of your posting fee.  You really need to rela and stop this unwarranted worrying.

1.  If you read the footbath post fully, you would see that it is a no risk event, no matter where it occurs.  Repeating the question does not change the answer.
1a.  See above
1b.  See above, no risk
1c.  Same answer, no risk.
2.  Correct, no risk
3.  yes

This thread will be closed later today with no further responses.  EWH
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82 months ago
Thank you so much Dr. Sorry I’m not sure you saw my other question 1d) in my last post - would this have the same response as for 1c)?

Thank you so much again