Hi, I'm just trying to get a bit of information about Hepatitis. About two months ago I had an encounter with a sex worker. Last week I got test blood results and the doctor said the liver results were slightly off. Doctor said it is most likely to do with some medicine I was taking at the time, but my anxiety obviously made me think about Hepatitis from this encounter etc.

In this encounter I gave unprotected oral (cunnilingus) and received unprotected oral, plus intercourse with condom.

Now, my question is. Was I at risk of contracting any Hepatitis from this? From what I've seen, and based on the fact the only hepatitis they test for at the STD clinic is B, Hepatitis B is the only one that could possibly be transmitted in a sexual encounter? I worried a little about this because I've read that Hep B is 50-100 times more infections than HIV and that it can it also be transmittable through the saliva. Not sure how accurate the information is, so wanted to ask someone who understands more about it.

The woman sent me test results where based on them, it seems like that she is vaccinated but perhaps not immune to it? I'm not sure if that's what it means, but it made me worry that she could potentially carry it and transmit it to others? Can you contract the virus and pass it on even after being vaccinated?

Welcome to our Forum.  I'll do my best to help but it would help to have more information.  The only type of viral hepatitis spread the penile-vaginal intercourse is hepatitis B.  Hepatitis C is rarely transmitted through receptive rectal intercourse.  There are no specific figures on the frequency of how often hepatitis B is transmitted sexually although it is estimated that it is more easily transmitted than HIV which is transmitted less than once in every 1200 penile vaginal sex acts and has never been proven to be transmitted through cunnilingus or receipt of unprotected oral sex.  Condoms are protective for hepatitis B.  Based on the exposures you describe, IF your partner had hepatitis B (which is doubtful if she was vaccinated for the virus), you are still not at meaningful risk for acquisition of hepatitis from the exposures you describe.  

There are many, many reasons that a person might have abnormal liver function tests including not only viral hepatitis, but many other viral infections, My advice in sorting out your slightly abnormal liver function tests is to get screened for viral hepatitis.  If you have test results, I will be happy to help you interpret them if need be.  I certainly would not be worried about having acquired hepatitis from the exposure you describe above.  

i hope this is helpful. Please use your up to two follow-ups if anything is unclear.  EWH

I'm 26 years old, non-smoker, not overweight and I rarely drink. I'm from Ireland. The sex worker was an independent sex worker and she was a little more expensive than the average sex workers in here. She showed me results from tests she did about a month before our encounter - as I was very worried back then. Not sure if this information helps, but it does give the idea she is careful about it I suppose. We had penile-vaginal intercourse with condom, I gave her unprotected oral for about 30 seconds - 1 minute, and she gave me unprotected oral for about the same amount of time. The only thing that bugged me a little is the fact that she may not have been immune to it even though she was vaccinated. I'm not sure I fully understood this or if I misread it. Is it possible to carry the virus and pass it on to others even after getting vaccinated?

About 2-3 weeks after this I did have a full STD panel test and I tested negative for everything including Hepatitis B, so this would be my only (possible) exposure to it. It seems like that the number of new cases of Hepatitis B in Ireland are very low (much much lower than HIV), so I guess her chances of exposure would also be very small.

Would the amount of Hepatitis B found in saliva be enough to infect someone through oral? Is the risk of cunnilingus more theoretically than anything else - so, it could happen but in rare situations? Would fingering be a risk to contract it assuming I had broken skin? or Does it need to be an open wound that's bleeding? I got vaccinated for Hep B as a baby, do I need another vaccine as an adult?

I do have another appointment this week. I was taking a few medications (antibiotics) around that time - including the night before and a couple of hours before giving blood. So, I'm hoping that's all it is. I am not sure exactly what was off, but doctor didn't see too worried about it since he knew about the medication.

Thanks for the additional detail.  I wish I could see her test results to help you with there interpretation. The hepatitis B vaccine is highly effective.  If she has gotten it, there is little chance that she ha it or can transmit it.  Further, the sorts of exposures you describe have no meaningful risk of acquisition of hepatitis of any sort.  

My overall assessment of your risk is that it is extraordinarily low, particularly now that I know that you both were vaccinated.  

As I said above there are no proven instances in which hepatitis B has been transmitted through oral sex (giving or receiving).  Broken skin would make no difference.  

I agree with your doctor.  While I do not know why your LFTs were abnormal, I have confidence that it is not related to your recent sexual activity.  EWH

From what I remember the title of the test had the words "Hbs"  and "anti". Then below it said that a value below  10 was non-reactive and a value about 10 was reactive. Her result was above 10, meaning it was reactive. She said that it means that her body created something (I don't remember exactly, but it had the word "anti" on it if I'm not mistaken, which based on what she said means she was protected against it).

Sorry I forgot the proper terms, but I hope that makes sense. I'm probably overthinking this anyway. I doubt she would send her results if they indicated something negative about them. Besides, based on your answers it seems like my risks were close to zero. Regardless, I appreciate the answers. Just one more question; would it be a good idea to get vaccinated for Hep B again as a 26 years old who was already vaccinated as a baby?

Thanks once again for the additional information.  If her test said that she has anti-hepatitis B antibodies of any sort, the was immune and count not transmit infection to you.  Since she had been vaccinated, you was almost certainly protected from the infection and thus could not have an infection to transmit to you. In addition, while not absolute, the fact that you were tested and found to be negative two weeks after your exposure is further strong evidence that you were no infected.  Further and finally, the nature of your exposure was essentially no risk for infection.  Given all of the information you have provided, you are seriously overthinking this.  I urge you to put it aside and move forward.

If you were vaccinated as a child, there is no need for additional vaccination, even if your own antibody levels have declined to the point where testing does not detect them. There is still a level of persistent, although undetectable protection.

As this is my 3rd reply, as per from guidelines, this thread will now be closed.  Please don't continue to worry about this.  EWH