Hepatatis

[Bdad1]

Quick question dr hook/dr handsfield
I've read that HIV does quickly outside the body bc of exposure to air, temp etc.  Is that the same for hepatatis B&C. I've seen that both HIV and Hep are very fragile to environment but some say hepatatis b and c r more resilient to air. Now is that a relative term and that both are not infectious once they leave the body or exposed to the environment it's just that hepatatis is a tad more resilient to air etc but it doesn't matter bc even though its more resilient that it still dies or begins to die to air and it is rendered unable to transmit or infect outside its host. Just wondering if hepatatis can be spread or contracted in the environment bc it seems that HIV can not but was wondering if the same holds true for hep b and c?  Thanks

[Edward W Hook, MD]

Final answers:
1.  Instantaneous- I don't know how you measure this.  I can tell you however (once again) that environmental exposure is not a meaningful risk for hepatitis or HIV.  You really need to relax about this.

2.  See above.
EWH

[Bdad1]

Thank you Dr Hook-
In reviewing this thread I actually have one last question and this is more of a question for me to know as a parent gong forward with these viruses..
Earlier in this thread u discussed how hepatitis b and c survive slightly longer in the environment than hiv but despite that they all die pretty quickly in the environment but they are considered non-infectious before they actually die.
1) Now am I correct in assuming that the process of them dying begins instantaneous when each virus ( in particular the hepatitis b and c and hiv) is exposed to air but they may not be completely dead instantaneously- however, they become non- infectious instantaneously bc the process of them dying begins right when they are exposed to air and temp etc rendering then non-infectious since the process of them dying kills any chance of infectious transmission???
2)The only reason why I ask is bc I know what to know if my daughter ever gets a cut and for some reason accidentally touches infected fluids or blood that she will be out of harms way and from acquiring such viruses in daily life by touching things in the environment???
If you could answer those two rather long winded questions/comments I will be on my way to leaving you alone my inquiries
Thank u doctor

[Edward W Hook, MD]

I'm afraid you are splitting hairs. There is no way to draw blood for medical purposes except to put a needle into the body.  Perhaps you overlooked my statement that- " I am not aware of any infections with HIV or hepatitis transmitted through blood drawing procedures."

You should not be concerned.  EWH

[Bdad1]

Thank you Doctor-

One last question for you. And I hope im not splitting hairs here bc I completely understand ur explanation of blood being drawn out vs goin in and appreciate ur expert advice.
But my last question would be if the nurse contaminated the needle (either the sharp end or body of the needle) w hepatitis b or c or hiv but especially hepatitis since its slightly more resilient to air and environment a way to transmit as infected blood would still be entering the body? Meaning that even though technically blood is being drawn out and not injected in a potentially contaminated needle still punctured the skin and entered deep into the vein. I guess that's how this all ties into my original question of hepatitis surviving slightly longer than hiv in the environment and that regardless of the flow of the injection a potentially contaminated needle still entered the body/vein.
Sorry for the specifics but if you could explain this final inquiry I would be greatly appreciative as a parent who is probably a bit more nervous than I should be but still ur expert advice to this last inq would greatly put at ease any lingering fears that I may still have. Thanks again and is this a zero risk event where I can never have to think out this again?

[Edward W Hook, MD]

I understand your concern.  There is nothing to worry about.  In fact, it may suprise you that the reason for gloves is to protect helath care workers from infection by their patients, not the other way around.  The direction of transfer in drawing blood is from the patient outward, not in the other direction.  I am not aware of any infections with HIV or hepatitis transmitted through blood drawing procedures.

Please do not worry.  EWH

[Bdad1]

Sent this again bc i wasnt sure if my last questions went thru- sorry if you received this twice sir.

Thank u. Very insightful. The reason I ask the question was bc I was a bit nervous regarding the fact that my daughter went in for a blood test and the nurse never changed her gloves from the previous patient. The office was in a bad area and many patients that didn't appear to hygenic at all to say the least and was worried that if somehow in the unlikely event that the nurse had infected blood from a hep b or c or HIV patient prior to my daughter and Touched the needle ( unlikely I know but as a parent I worry) if she could somehow get infected from hep b or c or HIV. Is this a zero risk event? Just worried as a parent and thinking the worst scenario. And if so why would it be zero risk since hep b and c appear to be more resilient. Thks .
And I'm sure u understand that when I say the nurse touched the needle I obviously meant that she could have contaminated the needle before injection and the  injecting the virus into her blood stream which sounds like it would be deep enough to cause transmission.  Thks again and look forward to ur response sir. .

[Bdad1]

And I'm sure u understand that when I say the nurse touched the needle I obviously meant that she could have contaminated the needle before injection and the  injecting the virus into her blood stream which sounds like it would be deep enough to cause transmission.  Thks again and look forward to ur response sir.

[Bdad1]

Thank u. Very insightful. The reason I ask the question was bc I was a bit nervous regarding the fact that my daughter went in for a blood test and the nurse never changed her gloves from the previous patient. The office was in a bad area and many patients that didn't appear to hygenic at all to say the least and was worried that if somehow in the unlikely event that the nurse had infected blood from a hep b or c or HIV patient prior to my daughter and Touched the needle ( unlikely I know but as a parent I worry) if she could somehow get infected from hep b or c or HIV. Is this a zero risk event? Just worried as a parent and thinking the worst scenario. And if so why would it be zero risk since hep b and c appear to be more resilient. Thks

[Edward W Hook, MD]

Welcome to the Forum. Your question is a good one and deals with a subtlety of the biology of these viruses.  Scientific study, as well as observation of enumerable environmental exposures has shown is that the hepatitis viruses are somewhat more infectious than HIV.  This is best studied for hepatitis B and estimates are that hepatitis B is about 10 times more infectious as a virus, than HIV.  Indeed, there are instances in which surgeons working in the operating room with patients infected with both viruses have been exposed through direct injection of infected material deep into tissue and have caught hepatitis B but not HIV.  Thus, these sad accidents have shown us that hepatitis viruses are SLIGHTLY more infectious for exposed persons than HIV.  Further, the two hepatitis viruses are also slightly tougher than HIV and outside of the body survive SLIGHTLY longer on environmental exposure than HIV.  Despite that, environmental exposure quickly kills all the viruses you mention quickly and they become non-infectious substantially before they die.  

Despite these small biological differences between the two viruses  however, years of experience has also taught us that, short of direct injection of infectious material DEEP into tissue, environmental exposure is simply NOT a meaningful source of infection for any other the viruses you mention - HIV, hepatitis B, or hepatitis C.  

I am not sure of the origin of your question but I can assure you that environmental exposure to HIV, hepatitis B, or hepatitis C is NOT a meaningful risk for acquisition of infection and should not be a concern.  

I hope my comment is helpful to you.  EWH