[Question #703] Worried about HIV and Hep C risks

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97 months ago
Firstly, I would like to thank the experts on this forum, you guys are doing a very good job answering questions. From what I have read on the forum, I already know the sort of answers I am getting, but just want to ask about my specific case.

So here it goes: Over the past a few months, I had two possible exposures, very stupid of me...

The 1st exposure: Unprotected insertive oral sex, protected vaginal sex.
Tests done after 1st exposure:
HIV (4th gen), done after 3 months (90 days) negative.
Syphillis, gonorrhea, chlamydia, Hep a,b all negative.
Hep c is done at 4 weeks (too soon, I am guessing)
Platelet count, liver function normal. (This two tests were done because I had something looks like Petechiae and Terry's nail..)

2nd exposure happened 3.5 months after the first exposure: full body massage + handjob + licking nipples
Tests done after 2nd exposure:
Doing a swab test for Shingles and Herpes on two blisters on my inner thigh. No other tests advised.

I have gained some basic knowledge from reading on this forum and Medhelp. But my major concern is regarding the first oral sex. The girl (CSW, status unknown) who performed on me have braces, so potentially bleeding gums, does that increase the possibility of HEP C infection. And what is the latest CDC guideline for testing of HEP C and HIV co-infection?

My second concern is regarding my second exposure, I had a sore throat on the day. Assuming there is secretions coming out of the masseuse's breast (there probably isn't), does a sore throat change your assessment of HIV infection?

Thank you again doctors for answering my questions.

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Edward W. Hook M.D.
97 months ago

Welcome to the Forum and thanks for your vote of confidence.  Before I address your specific questions about bleeding gums and hepatitis let me provide a little more general information about hepatitis C.  Until several years ago, many experts adamantly stated that there was NO sexual transmission of hepatitis C (we did not agree with this statement but did maintain that sexual transmission of this virus was very rare).  Since then it has become indisputable that hepatitis C is sexually transmitted but all data continues to indicate that sexual transmission of this virus is VERY rare and that the vast majority of sexual transmission, on those rare occasions when it does occur, tends to occur in the setting of receptive rectal intercourse, not genital contact and not oral sex,

With this as background, let me assure you that the exposures you describe did not put you at any risk for acquisition of hepatitis C. There are no instances in which either hepatitis B or C have been acquired from receipt of oral sex.  This is the case even when the person performing oral sex has bleeding gums, mouth sores, poor dental health, gum disease or braces.  Thus I would urge you not to worry further about risk for hepatitis C.

At present, the CDC recommends routine testing for hepatitis C only on persons born in the 1950s and 603, persons with HIV, persons who inject illegal drugs and persons with acute hepatitis.

The second exposure you describe was safe sex with NO risk whatsoever for acquisition of HIV. This is the case even if there were secretions coming out of the masseuse's breast.  That you have a sore throat does not change this in any way.  Still no need for HIV concern...or testing.

I hope these comments and fact are helpful to you.  Take care.  EWH 

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96 months ago
Thank you Dr. Hook, your quick response to my last question has been very helpful.

I am generally not very concerned about my exposure now. But sometimes the rash on my chest would still makes me uneasy and today I found a hard node under my jaw which got me anxious again.

The rash is very small red dots on my chest, which looks like folliculitis, but not sure, and I am seeing a dermatologist in 2 months...(thanks to Australia's health system). The red dots is not obvious in the morning, but may reappear during the day, it might form a lesion before completely heals.  I think I might have these even before my exposure, but my anxiety is probably clotting  my judgment.. Not sure about anything nowadays.

As to the "lymph node" it was because I have been having this tight feeling under my left jaw, and when I checked, it was a small hard node, can't be seen from outside unless I search for it with my fingers. I am quite skinny, so it may be normal and not swelling at all, but the feeling it could be a raised lymph node still makes me a bit worried.

Given my no risk exposure, I probably just need to hear your reassurance again. Sorry to disturb you with my annoyance, I will wait for my annual check up which is in 2 weeks to do a final test and put everything behind me. Thank you again Dr. Hook.
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Edward W. Hook M.D.
96 months ago

Consider yourself reassured.  The fact that you can feel a lymph node is of no concern.  I can't think of any patient in who I could not find at least one palpable lymph node and of the places I would expect to find them, under the jaw and in the neck are the places I would look first.  The node that you have been able to feel could represent a past or present dental cavity, gum disease, an "every day" viral sore throat or any number of other processes.  It is not a reason for concern.

Similarly, the rash you describe raises no concern about HIV for me.  I suspect these did exist prior to your exposure and that your anxiety and heightened awareness have casued you to focus on them.

Please try to relax.  Understand that the events you described above were not associated with any appreciable risk for HIV or other STIs and that your tests prove that you are not infected.  We typically close our question thread after two weeks or after three relies, whichever comes first.  Unless there is a final question, this thread will be closed later today.  EWH