Getting Hepatites C through Barber Tools

[ayman310]

Dear Doctor ,
I am very worried about poor decision taken in barber shoop . Uswaly i have my own tools including neck shaving tools , from 3 days back i missed only the cup of shaving cream & shared that belongs to shop .
It was just used by another person shaving & i ordered the the barber man to clean it properly by Boiler Water from 10 - 15 Secondas & from two times , which done .

I read some information on Wkipedia that C can live 8 minutes on 60 C & 4 minutes on 65 C & also is is affected by Chlorine water .Cosidering that i had small injury during my shaving .

Now , iam worried about getting C from the previous person who in unkown to me , considering that C in Egypt represent 15 - 20 % of population .

1. What is the possibility  of getting infection ? considering the following :
    - Effect of water on diluting the C Virus (In case) as the cup volume is 50 ML & max expected contamination will note exceed 0.1 ML , means 500 times dilution .
    - Cleaning the Cup by water which should remove the contamination . 2 Times
    - Effect of Boiled Water > 90 C on killing any infection . 2 Times
    - Effect of chlorine in water on killing the virus .
    - Effect of Sheaving Soap on killing the virus that used during the 1th & 2nd shaving .

2. In case of still there is a propability , when i shoul Test , what Type of Tests should be ?

Pls., iam very worried & waitng your support .

[Poorna Chandra, SMD, DM]

Dear ayman310,

In order to post a follow up question for additional answers, could you please copy and paste the original question and follow up question as a new paid question, so that your concern could be addressed as soon as possible by the doctor?

many thanks!

Dr. Poorna Chandra

[ayman310]

Many thanks Doctor for your kind support .
I will DO the the PCR after 4 Weeks , but as i am out of Egypt , the PCR is difficult & expensive .
I am still having unclear abdominal pain all side (Up, Down, Right & Left) .
I went to GP doctor without mentioned anything about HCV Exposure & Asked his advice about 15 days intermitted abdominal pain.

Directly he requested me to make Blood, Urine & Stool Test before any decision .
The result came as follows:
•Duration : 3 Weeks of After Exposure & around 2 Weeks after Abdominal pain .
• ALT  20    U/L          Range < 50 U/L
• AST  17    U/L         Range < 40 U/L
• Bilirubin :     Negative
• Urine :   White Pale
• Acetone :    Negative
• Pile Pigment :    Negative
• Blood : Negative
• Sugare : Negative
• Stool Color , Brown without  any problem

Cosidering that from 2.5 Months back , i make Lab Test for regular check & it was as follows :
- ALT    14  U/L
- AST    15  U/L

The Doctor said to me you have nothing & may be this from Anxiety Effect . Even i asked him for Elevated ALT & AST and the ALT became this time higher than AST . He siad all can happen normaly for any normal reason , it vaired around the time of sample during the same day. But the values still low .

Now i am tired & pain still there .
1. Is HCV Symptons can start after one week of exposure ?
2. If yes , it means that Virus Level should be high & detectable after 10 days ?
3. If this is the sympton that start after 1 week of exposure & still remain for 2 weeks that induce Abdominal Pain Only, ALT levels should go higher than this ?
4. Any other possibility for the pain ?

I am realy need your adivce now , as i am working in remote location with very limited Facilities & Advice .

Regards ,
Ayman  
Is it can be early stage of Acute Infection & ALT will go higher in the incomming periods .

[Poorna Chandra, SMD, DM]

Dear Ayman310,

The HCV RNA count is reported as <15 IU/ml as this the lower limit of detection of this test. Even if it is negative it will be reported as <15 IU/ml. As the tests get better the lower limit of detection goes on decreasing (earlier it was <200 then <80 and so on). So technically you are not infected.  The viral load after an infection is a function of the HCV genotype, the infectious inoculum and the immune status of the recipient. If you still want to be 100% sure you can repeat the same test at 4 weeks.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra K.S

[ayman310]

Dear Doctor ,

Any further support .

Regards,

[ayman310]

Dear Dr. Chandra ,

According to your recommendations , i did HCV RNA Quantitative by TaqMan , Realtime PCR as follows :
- Result < 15 IU/ML  (Below Detection Limit)  
- Time : 10 Days After Expected Exposure
- Lab Type :The COBAS Ampliprep/COBAS TaqMan (CAP/CTM), a fully automated real-time PCR used to monitor HCV viremia during treatment of patients with chronic hepatitis and patients undergoing
antiviral therapy.  The wide dynamic range of the (CAP/CTM) allowed for a better definition of viral kinetics for all HCV genotypes (1 - 6).
Results are reported in international units (IU).
1 IU/ml Corresponds to approx. 5 Copies/ml.

      -  Based on the above Data :
1. Is this confirm that i am free from HCV 100 %    ?
2. As mater of sience , what is the minimum Expected Virla Load Recorded after 7 or 10 Days Of Exposure    ?
3. If still there is porpability for +Ve HCV , What other Tests / Durations requird for it ,such as Repeat PCR , HCV-Ab or Liver Enzyms    ?

I am now 14 Days After Exposure & i feel pain in lower left side of stomach , which started after 5 days of exposure , but i have no direa .

Yuor usual support is hihgly apprecited & i am litile bit worried & i hope to close this chapter .

Thanks & Regards  ,

[Poorna Chandra, SMD, DM]

Hi Ayman310,

There is no specific data regarding effect of dilution but thorough mechanical cleaning is the first step at disinfection.

HCV is resistant to boiling and the hot tap water may not matter. Presently available PCR assays are very sensitive and can detect acute HCV infection in first week of infection.

The publications have to be interpreted with respect to the time of study as the sensitivity of these assays are progressively improving and the routinely available current assays detect upto 20 HCV RNA / ml.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.


Best Regards,
Dr. Poorna Chandra K.S

[ayman310]

Dear Doctor .

Any further support , at least for question no.2 , PCR related @ cosidering that other Medhelp Forum (Ex. for HIV) , they extend their support up to 3 -4 time .

Many thanks & your usual understanding will be higly appreicted .

[ayman310]

Doctor ,

We ment by dilution is diluting of blood of the 1th customer (before me) & in case of bleeding for around 500 times by shaving water .
Although that all this contaminated water had been scavenegd in the water basin by Boiled Water > 90 C inorder to make sterilizing & for 2 times . 10 - 15 seconds in each time .

Pls., support

[ayman310]

Thank you Doctor & kindly consider the following :

1. All contaminated water had been scavenged (Removed) by Boiled Water during cleaning on water basin by Tap water & iam only afrid if any virus may still touching & living on the Cup Internal Serface after 2 times cleaning .
2. Regarding PCR is it required Qualitative or Quantitative , some article mention 2 Weeks , what is the Relaiability Percentage for 1 Week & 2 Weeks .

Pls., support

[Poorna Chandra, SMD, DM]

Dear Ayman310,

I have noted down the details specified in the query and I admit that this is a difficult question to answer in terms of statistical possibility, as there are no definite reports available on these facts.

HCV is mainly transmitted via blood and blood products and the risk of infection basically depends on the viral load in the host. The most effective way of sterilizing the article contaminated with hepatitis C is 'autoclaving' alone. Boiling does not help but bleach used in 1:10 concentration helps. The effect of detergents on HCV virus is not well established.

In your scenario the risk appears small as:
a) There was some mechanical cleansing and dilution
b) HCV is an enveloped virus and is susceptible to detergents

Though the risks are small, to be on the safer side I would suggest a Hepatitis C (HCV) antibody assay after 3 weeks or a HCV RNA polymerase chain reaction (PCR) test after 1 week.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra K.S