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Sexual exposure risks for HepC
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Sexual exposure risks for HepC

Hi everyone,

I recently had an exposure to HepC (potentially). It was sexual, with protected vaginal sex and unprotected oral. I read on the forums that this is viewed as a very low risk (if any) for transmission.

I was especially concerned because there was quite a lot of fingering involved (me to her), I know that HepC is carried in the blood, and I read that this includes menstrual blood.

Is this considered high risk?

Also, I've tested negative for antibodies at 18 weeks. Is that considered a safe time period? Am I in the clear?

Thanks in advance,

Pete.
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217229_tn?1192766004
Well Pete - methinks unless you both had openly bleeding wounds and you were exposed to someone who had HCV --- then methinks you're ok.

Dunno if you're in the clear - keep getting annual testing --- but yeah - it's a blood to blood disease - and sex transmission is very low.

Good luck - and stay clear.

Meki
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Avatar_m_tn
Pete,

      You are well on your way to becoming a 'worried well.'  That is, someone who is neg for an illness but cannot accept that, continues to worry about it and test for it.  The old saying is, 'It takes one to know one.'  I was in your shoes two years ago and worried so much about Hiv and hcv that i made myself sick.  DO NOT fall into that trap.

Your 18 week neg is good as gold.  If you want to test again at 26 weeks, Ok, do so.  Unless you have put yourself at risk again, that test will be NEG.  Stop worrying and get on with your life.
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Avatar_n_tn
Hi Jackied,

I think you are right. In fact, in some ways I hope you are, because at least then I'm 'well', albeit a worried one.

But seriously, it's something I'd like to sort out. Despite everyone telling me that I'm OK, and that I haven't even put myself at risk in the first place, this is starting to consume my life now. As someone who's been there before, how did you break the cycle? My plan was to accept my worry until I can do a definitive 6 month test, and hope it gets better from there.

What did you do to stop worrying, testing, etc?

Pete.
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Avatar_m_tn
Pete, take it one day at a time.  Did you keep the 18 week neg test result?  Put it in a safe place, and whenever you worry about being pos for hep c, look at it.  I'm sure there is a phrase which reads,

'patient's sample is neg for hcv antibody.' (or something like that)  instead of testing again, just read that 18 week result.

For your peace of mind, get a 6 month antibody test.  Forget the pcr.  Too expensive at this point and your 18 week neg is 99.9% definite.  Your six month test WILL BE neg.  If you were to test pos now, you would be the unluckiest person since Custer.  After your six month neg, if you cannot accept your good fortune, see a psychiatrist.  That will help.

For now, replace the thought 'I may be pos for Hcv' with the thought 'I know I am neg for Hcv.'
Good luck.
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Avatar_n_tn
Hi Jackied,

cheers for your words of encouragement. I think one thing I should do is stop reading the Internet. There's so much conflicting information around it's unreal.

Thanks again,

Pete.
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Avatar_m_tn
Definitely, stay off all the hep c internet sites.  Too much info.  Consider volunteering or mentoring a young person.

Use this as a learning experience and remember the worry and anxiety the next time you are tempted.  It is NOT worth a 6 month HELL.  Trust me on that one.

I don't know if you are religious but consider going back to church.  Help others less fortunate and you will forget the worry.

Put this behind you and move on with life.
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Avatar_n_tn
How bad did you get then Jackied? What kind of things did you imagine?

Pete.
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Avatar_m_tn
Well, my risk was like yours, protected sex with a pros.  Worried sick.  I was sure I had Hiv at first, and the pcr test for hiv was neg at 40 days then I had a neg antibody at two months and 15 weeks.  Then I imagined i was pos for herpes and had a neg test at 4 weeks and 15 weeks.  So i was over the fear of hiv and herpes.

Then I imagined hepatitis b and c. had a negative antibody at 8 weeks and 12 weeks.  So i was feeling pretty good about things and decided to have a final test for hep b and c at 15 weeks.  the hep b was neg but the antibody for hep c was 'fuzzy.' maybe reactive, maybe not.  The lady at 'request a test' suggested the Riba test which is VERY specific for Hcv.  Waiting for that was the worst 4 days of my life.  I heard the magic word, neg, and that was the happiest day of my life.  I later came to find out that the screening test for hep c is VERY unreliable and many reactive screening tests are proven false reactive by the riba test.

I was somewhat relieved by this but I knew I had to know if the virus was in my blood stream.  So i had the wonderful Pcr by Rna, qualitative , test done.  VERY expensive, $565.  It was worth it though because the result was, thankfully, neg.  qualitative Pcr is more sensitive than the quantitative.  

So I had to go through some extreme worry, anxiety and shame but now all is well. I had become a 'worried well.'  After finding out about the risk factors for hcv, I never should have been so worried but your mind plays tricks on you.

I am worried you will fall into the trap that held me prisoner for a long time.  Believe me, it is awful.

get your test at 6 months, (I promise you it will be neg) and forget it!!  

I have a lot of admiration for the 'heppers' going through treatment and say a prayer for them every day at Mass.

I spent a fortune on all the  tests but I was so worried and scared over what.  Nothing, I can now live my life knowing I am neg for hiv/herpes/hep b/hep c.
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Avatar_n_tn
Hi Jackied,

cheers for that. It does sound like a nightmare. Did you go through what I'm experiencing, including a few 'symptoms' as well?

My story is this. I had a potential exposure 18 weeks ago. Everyone I've asked on helplines, etc, has told me that what actually happened didn't represent any real risk. From there, I started to look online about what could go wrong. I had a full STD screen at a GUM clinic at 6 weeks, which was negative for everything, but not HepC (as it's not tested as standard). From there, I was told that the test window for HepB and HIV was 12 weeks, so re-tested privately at around 9 weeks, and through a GUM clinic at 12 weeks and they came back negative.

From there, I was told that HepB can sometimes take 6 months, so I began to panic. I've looked online, and opinion seems to be that HBsAg is detectable at 12 weeks, although some disagree (which you get on the Internet with all the fear, etc floating around). What followed then was a series of further tests for HepB at private clinics and GUMs, trying to put my mind at ease. Until then, I'd discounted HepC, as I'd seen  how it is and isn't transmitted. However, something inside me changed, and now that I've realised that my HepB test is probably reliable, I'm now becoming worried about HepC. I've since tested negative for HepC and HepB at 15 and 18 weeks.

To make matters more complicated, in the middle of all this, I began to poke and prod where my liver is, to see if it hurt. In fact, I think I've prodded it so much that I think I've hurt the muscles and ribs in that area, and now feel discomfort there quite a bit. Of course, I'm sometimes interpreting this as a 'symptom'. Also, a few weeks ago, I began to itch all over. I saw my doctor about this, who ran some LFT tests for me because I told him I was concerned, and these came back normal. I understand that ALTs are normally raised with acute HepC, and are over 10 times their normal limit in over 80% of cases. I understand that itching can be a symptom of many things, and that stress and anxiety is the number one cause.

Anyway, despite all the advice I've received (including from Dr. HHH on the Ask an Expert STD forum), I'm still worrying, and am now trying to figure out what to do for the best.

I'm beginning to realise that a lot of this has to do with my anxiety rather than any other basis. I've also decided that even if I tested again at this point, I still wouldn't believe the result until the 6 month mark, and so have decided against a further test for a while. If I was being rational, I should believe the results now. Plus, I'm a bit scared about getting a false positive, and what that would do to me.

By the way, I had the chance to have a PCR test, but decided not to. Not because of the cost (although it is expensive), but because I've read on the forums and elsewhere that there is quite a good chance of a false positive with it, unless it's carried out to certain very strict standards. I'm in the UK, where high quality health care is provided for free. But because of my shame/guilt/etc, I didn't want to go to my own doctor for the tests, plus, they wouldn't continually test me anyway. For that reason, I've had to find a private clinic to do my tests, and I'm not sure if the standard that the lab practises at would make a PCR reliable. For example, I found out that they send all PCRs off to another lab, which will mean it would be a couple of days before it was tested. I read that to avoid false positives, they would need to begin testing sooner then that.

Anyway, there's my story. Please feel free to comment. It's been quite useful typing it all down. I can kinda see how irrational I'm being with my over-testing.

Cheers,

Pete.
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264121_tn?1313033056
When I was exposed to hepc, my test came back strongly positive about seven weeks after my exposure, if that helps you any.  Prior to that, I had been screening for HIV and HCV quarterly due to an old relationship I'd been in where I was concerned about some fidelity issues.  So I had a good backdrop of negatives, a known exposure, then a positive test about seven weeks later.  

Not many people are able to isolate their exposure to the virus, so you aren't going to hear much in the way of this type of anecdotal feedback because it doesn't happen all that often that people are aware they were exposed and actually test due to that (except perhaps in healthcare settings with providers).

Also, it is difficult to spread HCV via sexual activity.  It is even more difficult for the male partner to get it from the female.  The female, considered the "receiving partner" is the one at risk in these situations, which are rare.  Women have a large area of internal mucous membrane that can abrade and allow much more surface area for transmission (as can receiving males in anal sex situations for the same reason - the mucous membrane lining the rectum).

The penetrating male partner in both of these situations is the one least at risk.  And as for oral sex, saliva does not spread HCV.  It's great that you got tested because my feeling is that it doesn't hurt to test, and if more people would test at least once as adults, we would reign in this disease sooner.  On the other hand, you are being REALLY REALLY neurotic about your negative test results LOL

No offense ;P  But just take a xanax and drink a glass of wine and relax (cuz most of us can't drink wine anymore.)  
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Avatar_n_tn
Funny that you should say that Alagirl, because I haven't had a drink since I became neurotic! Would you trust the 18 week result, based on what you know about HepC?

Cheers,

Pete.
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264121_tn?1313033056
In YOUR case, since you don't EVEN have a valid exposure, absolutely.

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Avatar_m_tn
The "worried well" syndrome is often seen in many forums.  I can think of one forum (AidsMeds) that has a forum specifically for those who fear they have been exposed to HIV.  They manifest AIDS like symptoms virtually overnight and cannot seem to shake them often even after testing proves that they are negative for the virus.  All that I can say is that the mind can have a very strong impact upon the body. This repeats itself over and over in many people.  I believe that it also occurs in many of us when we are correctly diagnosed with HCV.  Suddenly symptoms can appear.  It can also happen to people who clear the virus but have nagging fears about the latest fever, fatigue, or infirmity.  

It is one reason that I prefer to think very positively about my HCV infection.  I may not be able to think myself into being clear of my HCV but I may be able to steer clear of an ulcer, insomnia..... yadda, yadda, yadda.  I seriously believe that living in fear will hurt us.  (whether we have HCV or not).

good luck but I think you'll be fine,
Willy
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Avatar_m_tn
I believe the timetable for testing is as follows:

50% will be antibody pos at 50 days

90% will be antibody pos at 100 days

close to 100% will be pos at 180 days
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Avatar_m_tn
Pete, get a grip.  Here are the facts.

1) You are not sure your partner has hep c.  Good chance she does not.
2) Sexual transmission of hcv is rare, even more so female to male.
3) You have an 18 week negative.

Let's look at the worst case scenatio.  Your partner has Hcv and sexual transmission is a primary way to transmit.  If this were true, you would be at high risk.  

However, you do not know the answer to #1 and you do know sexual transmission is rare.

The best thing you have going for you is the 18 week neg.

One thing you could do, if possible, is contact your partner and ask her to be tested.

Even if she is pos, remember sexual transmission is rare and you have an 18 week neg.

If she is neg, end of story.
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