[Question #4895] Risk of HIV and Hepatitis

27 months ago
Hello doctors,

I was out with a couple of friends last night. After a few drinks, my guy friend kissed me. In the act, he bit my tongue and it got a cut. I do not know his status and I am now worried about contracting infections like HIV and Hepatitis. Is this possible? I don't know what to do to put a stop to my mind going into overdrive. What should I do next? 
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to the Forum.  I'll be glad to comment.  I am going to presume that you are here in North America - if that is incorrect let me know.  The reason I bring this up is because where you are, as well as what you know about this fellow influence the likelihood that he had either HIV or hepatitis C, both of which are quite rare in North America. , particularly among non-IV drug using heterosexual men and women.

The bottom line however is neither of these infections is transmitted by kissing.  As far as the bite is concerned, any blood present was yours, not his and thus this too would be very low, and probably no, risk for acquisition of infection.  I would urge you not to worry about this event and see no reason for you to seek testing related to it.  

I hope this comment is helpful.  If there are further details that you would like to share or if you desire clarification, please don't hesitate to use your up to 2 follow-up questions to seek clarification.  EWH

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27 months ago
Thank you for your response and sorry for not writing down my complete details. Yes, I am in NYC and this happened at a club in NYC. He is an Indian guy who moved here 3 years back and studied at Columbia University. I was tested as a routine physical 5 months back, and came back negative. I did ask him if he was ever tested to which he said he got a full body check in December in Delhi, India, but I doubt it had HIV or any other STI tests included. My tongue was red and swollen after the event until now. Do you still feel no testing is required? please let me know if you need any more details.
27 months ago
Also, I dont knw if he had any open sores on the tongue or any bleeding gums, to put me at risk.
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
 Thank you for the additional details. HIV is somewhat more common among heterosexual men in India than in the United States but still rather uncommon. I would still consider this a low risk event for HIV or hepatitis.   I should point out however that human bites sometimes become infected with bacteria from the biter's mouth. If the swelling around the cut has not begun to improve in the next day or so I would suggest seeing your own doctor.  EWH---
27 months ago
thank you & yes, I will definitely do that. so there is still low risk for the infections to be transmitted to me from this event? do you recommend me getting tested? if yes, when? 
27 months ago
I came across this FDA approved HIV RNA early detection testing that gives conclusive results in 9-11 days after exposure. How reliable is this testing? I know it is pretty expensive but i would still like to get tested for my own satisfaction at the earliest.
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
I wish I could tell you that there is no risk but unfortunately, all I can say is that the risk of this event if very, very low.  Thus I can understand that you might choose to test.  The most direct and quickest way to an answer if for the person you kissed to be tested.  If he is negative at this time, there in no risk to you.  On the other hand, if you choose to do the testing yourself the HIV RNA detection tests you mention are very good- these are the tools that are used to keep the transfused blood supply safe as every specimen collected for transfusion is tested with them.  As you point out, alternatively, you could wait and get tested with the far less expensive tests routinely used.  Combination HIV antigen/antibody tests are 99+% sensitive for infection detection at 4 weeks and completely reliable at 6 weeks after a potential exposure.  these are the options.

I hope these answers have been helpful to you.  As per Forum guidelines, this thread will be closed without further replies shortly.  Take care.  Please don't worry.  EWH
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27 months ago
Thank you for your reply Dr. hook. Just 1 last question so I know my next step of action. It is still less than 72 hours. do you recommend me getting Post exposure prophylactic treatment??? Thank you for evrything. you are too kind. god bless
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
This was a low risk event with a partner of unknown status.  I do not recommend PEP in this situation.  EWH---