[Question #7861] Heb B and other STDs
51 months ago
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Hello Doctors:
This forum helps me when my regular doctors don't know the answers. Sorry my last question for awhile. Since you are the experts and very detailed in your answers here goes:
On March 20, 2021, I received dose #2 of my Hep B vaccine.
I had unprotected vaginal sex on April 10th at night and in the morning on April 11th with the same person. I didn't perform oral sex on her. [My regular DR put me on PEP after the sex encounter on April 12th and I finished it on May 10th, 2021. He thought maybe I should because I do have Genital Herpes, although I didn't see any lesions on me at the time and I am on Valtrex.]
On April 19th, she performed oral sex on me I was on PEP at the time.
Later, on April 26th, 2021, I had a Hep B Surface AB Pre/Post HBIG INFUSION test and it came back 293.
1) Does the 293 result mean I am protected from Hep B? I did have unprotected sex on April 10th and 11th.
2) The night I had sex on April 10-11th was 21 days after Dose #2 of the Hep B vaccine would I have been protected from that encounter?
3) Let's say I do have Hep B, can I pass it on to a woman via oral sex on her (cunnilingus)? or through kissing?
4) I was tested for Gonorrhea, Chlamydia, and Syphilis 4 weeks and a day after the April 10th encounter and they were negative, can I trust those results?
Thanks again for answering my questions. I referred this service to a friend of mine.
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Edward W. Hook M.D.
51 months ago
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As you know, I suggested the encounter you continue to worry about was a virtually no risk event and would not have put you on PEP. I have also urged you to work to move forward without concern and am saddened for you that you seem unable to do that. Brief replies to these somewhat repetitive questions below.
1) Does the 293 result mean I am protected from Hep B? I did have unprotected sex on April 10th and 11th.
Hepatitis B antibodies greater than 10 are considered protective. This is a high, protective antibody level.
2) The night I had sex on April 10-11th was 21 days after Dose #2 of the Hep B vaccine would I have been protected from that encounter?
Most probably
3) Let's say I do have Hep B, can I pass it on to a woman via oral sex on her (cunnilingus)? or through kissing?
Where do you get the idea that you have hepatitis B. I see no evidence that this is the case. There are no data that hepatitis B is passed through kissing, including open mouth kissing, or cunnilingus.
4) I was tested for Gonorrhea, Chlamydia, and Syphilis 4 weeks and a day after the April 10th encounter and they were negative, can I trust those results?
Once again, these result should be believed.
EWH
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51 months ago
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Thank you Dr. Hook for addressing my unfounded Hep B concerns. It just worries me as I did get genital herpes and statistically speaking I still got it when it's "tougher" for a man to get it than a woman. I was in a long-term monogamous relationship at the time when I got GH. So I wonder if I would "beat the odds again."
As you know my unprotected vaginal sex encounter with a woman I just started to date was from 4/10 into 4/11. I started PEP on 4/13 and finished the course on 5/11.
1) Since you say the "clock resets" for reliable HIV testing after I finish PEP, when would I be able to test and trust the results? Can I do an RNA HIV test 14 days after I stopped PEP? Or should I just wait for the 4-6 week mark and get an ab/ag 4th generation test?
2) I also read somewhere if someone has Genital Herpes they are more likely to get HIV from encounters because of the T cells and HIV is attracted to that. Although I didn't have any open lesions that I knew of at that time. Should I be concerned with that all?
3) Lastly, I did have my first Covid vaccine shot on 5/14 (Pfizer). I did feel achy the next day which I expected. However, I have felt some minor body aches from time to time over this past week. Would that be consistent with HIV seroconversion symptom if PEP failed? Or would PEP affect or delay HIV seroconversion if it failed?
I'm upset with myself for not using a condom actually. It's hard to admit but I am upset.
51 months ago
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I should also add I had Covid, a minor bout, just a high fever at the end of March. But I am still concerned the slight body aches tho. I don't think they're related to my covid shot, which I got over a week ago.
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Edward W. Hook M.D.
51 months ago
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Many of these questions were answered during our prior exchanges. Straight to the questions:
1. Most experts STIs suggest a six week combination HIV antigen/antibody test at the completion of PEP, even for persons who choose to have RNA tests prior to that.
2. The increment is slight, your risk as I’ve said before was virtually zero even without PEP, I would not worry.
3. Vague aching longer than a day or two following PEP does not suggest HIV seroconversion.
EWH
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50 months ago
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My last reply for this thread.
1) I got tested for gonorrhea and chlamydia at 4 weeks from unprotected vaginal sex. Both negative. However, when I did my specimen, I didn't pee for at least 30 minutes beforehand but I let the first bit of urine go into the toilet before I let it go into the specimen cup from my penis. Would that affect the results like a false negative? (There was a sign in the bathroom saying count :02 seconds of urine before collecting it in the cup.)
2) I did notice a slight pain in or around my penis when I am close to finished peeing and a little sensation after. I have not noticed any burning or discharge from my penis. Sometimes in between bathroom breaks I'll just be sitting and I will feel a "pulse" of the same pain once. It's a very dull ache. This has happened a few times today. Is this anything to be worried about or is it just me being too focused on STDs? I have been anxious and stressed recently. I only noticed this today at 6.5 weeks from the same unprotected vaginal sexual encounter.
3) Could it be Trich?
4) Also negative for Syphilis at 5 weeks. Just an FYI. That should be trusted?
and again thanks for your detailed responses!! Your knowledge is quite a service.
50 months ago
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and I should note, the pulse ache (best way to describe it) is either in my penis or just above it. I just wanted to add that detail. Is that typical of an STD type ache?
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Edward W. Hook M.D.
50 months ago
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Sigh. I’m so sad that you are having so much trouble moving on. You need to. In answer to your questions:
1. Beginning to void before you collected your specimen does not change the validity of your results. Believe them. You do not have Gonorrhea or chlamydia.
2. This is called genitally focused anxiety. If you look for symptoms, you will notice normal sensations. These symptoms do not suggest and STI.
3. No
4. Yes
Thanks for thanks. This will complete this thread. EWH
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