[Question #842] Hepatitis B

52 months ago
Evening I have done a battery of tests after my exposure with an escort which was protected until the condom slipped and I was exposed maybe 5 to 10 minutes before completion. I know that I can rule out HIV infection as all my tests were negative Rna/antibody week1, 4th gen and Rna week 4, 4th gen tests at weeks 7and 9.  My concern now is hep b My records indicate i took 3 shots but for some reason i dont trust them. I have asked my doctor to do blood test to see if i am immune or of i am ok.   Other than that i took 2 comprehensive tests on week 4 (3 weeks 6 days) and on week 9( 9 weeks 3days).  My fear is if i wasnt vaccinated would my hbsag tests on week 4 and 9 weeks 3 days be enough for me to move on if in fact i am not vaccinated or immune?   Im hearing 12 weeks is conclusive as well. Does this hbsag test really indicate that i am fine? Really worried. The online std site says i should be confident and their doctor consulted me saying my tests indicate i have nothing. Its reassuring but would like to know if i can move on from this or need to retest at 12 weeks or anything else.   Please look at my last question for reference if needed thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
52 months ago
Welcome to the forum. Thanks for your question.

I don't understand why you don't trust your immunization against hepatitis B virus (HBV). It's one of the most effective vaccines. You can't catch it, period.

Second, the chance of HBV from any single heterosexual exposure is almost zero.

Having said all that, did your "comprehensive" tests include HBV testing? If so, what were the results? Testing can tell whether you are immune. If you will tell me your results, I'll be happy to interpret them. They should include tests for hepatitis B surface antigen (HBsAg), antibody to HBsAg (which will be reported as anti-ABs or as HBsAb), and antibody to hepatits B core antibody (HBcAb or anti-HBc).

In the meantime, I see no reason for you to be at all concerned.

Regards--  HHH, MD

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52 months ago
Hbsag tests were negative just for clarification. Man! I was scared about hiv and with that resolved im really scared about hep b.  I know my records indicate im vaccinated but im sacred that they were annotated in my record and not administered to me  which has me thinking the worse that im not.vaccinated.  Can the hbsag tests at 4 and 9 weeks alone be a good indicator for me if not.vaccinated IM REALLY SCARED AND MY.WIFE KNOWS MY.CONCERN.  I can only hope being exposed after condom slipped for 5 to 10 min wasnt enough to get me infected.  Just thought id clarify
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
52 months ago
Your negative HBsAg result indicates you weren't infected. But it's the HBsAb test that's important. If positive, it would prove you are immune from being vaccinated. What was that result?

I don't mean to be insensitive, but there is no rational reason for you to be so scared, or to suspect that somehow your health records would indicate you were immunized when you were not. That's patent nonsense and you know it.

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52 months ago
I meant im afraid they faked giving me my.vaccine.  Which has me unsure ofy.records. ...the only tests done in reference to hbv was the hbsag that i did thru analyte health (stdexpress.com) .  I read in past forums of yours doctor Hunter about the hbab and hbcab test i think thats what scared me most was that they only did hbsag and that was it. Im pray just those 2 tests alone are sufficient to rule out hbv IF im not vaccinated. I already asked my personal medical department at Camp Pendleton to do a blood test.to see if im immune or clear from infection. They said of they find im not immune theyll give me a booster. Im praying i am immune amd that they did in fact adminster those shots if not im hoping there was no infection.  Im a huge fan of yours and Dr Hook as i read.as much as i could of archived forums of both.You all do a great service I wish you both were doctors here in the military...at least wed know we habe two very knowleda le docs helping us servicemen.
52 months ago
Thats the thing sir, i dont have the results for the hbsab after i seen some other forums suggesting to get tested for that...it scared the hell out of me enough to call my primary care manager and department to request a full blood work up on my liver and in reference to HBV as i told them i wasnt sure they gave me the vaccination.  They said to come by monday the 13th and that ill get the results a week from the 13th....Sir im scared my unit may have transcribed my record without giving me those shots becuz of it im assuming im not vaccinated so im trying to assess my.situation as if im not immune. But if your saying.my 4 week and 9 week HBsag are sufficient i can relax more.  I was.afraid the atigen test alone wasnt enough to rule out infection.  Again ill know a week after i get.my blood draw..i hope ill be immune and if not then not displaying infection.  
52 months ago
The other reason im having doubts is on my records it say i had 3 shots for anthrax when i only had 1.  Its that incident that has wondering about my hep b vaccination info. Just thought id put that in there to explain my fear and doubt
52 months ago
Sorry about additional posts. Based on my HBsag test results at 4 and 9 weeks with that particular test by itself.  Can i resume normal and not worry about passing this to wife thru sex can i rule out HBV?  Also i will follow up with the blood work i requested in a week sir
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
52 months ago
"I meant im afraid they faked giving me my vaccine." I knew that's what you meant. It's still nonsense, regardless of the anthrax vaccination records. HBV vaccination is a very high priority in the US military, far more important than anthrax. You still should assume you adequately vaccinated against hepatitis B.

Even if the blood test (that's the HBsAb test) shows no definite immunity, a booster probably will make no difference. Such people have lifelong immunity and don't catch HBV if exposed. The booster is done as a precaution but probably is unnecessary.

And remember my initial comment: the chance you were even exposed hep B is extremely low. Although it can be sexually transmitted, it rarely is; it is unlikely your escort partner had HBV and if she did, very unlikely you caught it (far less than 1 chance in a thousand). And your negative HBsAg tests prove you weren't infected anyway. I don't understand why you are so obsessed about it. You should never have stopped sex with your wife, and certainly should resume normal sexual relations with her at this time. With your negative HBsAg tests, you cannot infect her -- period.
 
Thanks for your kind comments about Dr. Hook's and my services. But it appears you are in competent hands, and I would suggest you entirely stop searching for our past comments about hepatitis B. Indeed, you should stop searching the internet entirely.

That completes the two follow-ups included with each new question, and so ends this thread. Do your best to move on without further worry about all this.

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