Concerns with contagion

[bthai44444]

.Doc,

I live in Thailand and have grown close to a women who is HepB positive.  Thus far, all we have done is have had oral sex as i am concerned about the disease.  She is not positive for anything else.  I have a few questions.

1.  When having oral sex the other night, i had a sore/cut in the inside of my upper lip that was pretty nasty and i was wondering if it increased my chances of getting HepB, i know it is extremely unlikely to get HepB from oral sex but wonder if the above factor changes anything?

2.  About 6 years ago i got the HepA/B series of shots, and have know found out that in some cases they do not take or work sometimes......is this true?  If so, how do i know if mine worked and I am immunized?

3.  I would like to have interecourse with this women, but am concerned about question #2, and also i have read from the web that the vaccine, if it works and you are immunized, the vaccine is still only 90% effective against HebB.  What are the odds of catching HepB from an act or intercourse, and how does this vaccine protect me longer term?

4.  If i use condoms, what are the odds of me getting the disease from her if the vaccine did not work.  I assume if it is working, then it reduces these odds in whatever question 3 is accurate.

Sorry in advance for the all the questions and i really appreciate your help.

Best

[H. Hunter Handsfield, M.D.]

I was not aware a candida blood test even exists and certainly have never used on in my patients.  I can't say what that result means.  But everybody gets candida infections from time to time, and most of us carry it on our skin, in our intestines, etc.  So I would expect most people to have positive results.  In any case, candida is not an STD so it's outside the realm of this forum.

Your hepatitis A antibody test shows you either have been vaccinated against it or had a hep A infection sometime in your life.  There is no way to know which, but at this time you are immune to it.

That's for sure the end of this thread.  I won't have any more comments or advice of any kind.

[bthai44444]

Hep A, am i immune and also should i worry about the intermediate Candida result.  tx so much!!!!!!!!!!!

[H. Hunter Handsfield, M.D.]

Except for the HBV result, you were seriously overtested; there was no need to spend money on most of the tess you had.  But all results are normal.  The vaccine worked; you are immune to HBV.  

That will end this thread.  Take care.

[bthai44444]

STD SCREEN RESULT UNIT REF.RANGE
VD (Syphilis TP Ab) △

[bthai44444]

Doc,

Below are my results.  I cannot understand them, but believe the immunization worked, can you please look at them.  Also, on another note, i had a Candida test as well and it came back at a 5.3, is that something is should worry about and is there anything else in the test that is worrisome?  I don't even know what Candia is.  I will post a new thread if you think we need to have a more indepth discussion..  Thank you so much for your advise.  Best,

GENERAL PROFILE (SCSTBU)
URINE CULTURE
Microscopy
Culture
No bacterial growth after prolonged incubation of 48 hours.
Urine culture attempted twice. Possible non-viable organisms seen.

HEPATITIS PROFILE     RESULT                UNIT           REF.RANGE
Hepatitis Bs Antigen B      Non-Reactive
Hepatitis Bs Antibody B    REACTIVE 705    mIU/mL       >=10 Reactive
Anti-HAV Total A               > 100.00                mIU/mL       >=20Reactive
Anti-HCV C                        < 0.1                       Index           Interpretative Values
Non-Reactive : = 1.00

TEST NAME          RESULT
HIV I/II Antibody     Non-Reactive

STD SCREEN                          RESULT            UNIT             REF.RANGE
VD (Syphilis TP Ab) △

[H. Hunter Handsfield, M.D.]

Noted; see above.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your questions.

2,3) I'm going first to these, because they contain the most important information you provide -- that you were immunized against hepatitis B virus (HBV) 6 years ago.  You can be very certain you are protected.  Although it is true that the vaccine isn't perfect, it is over 90% reliable -- probably close to 99%.  If you would like to confirm your immunity, you could be tested.  Having been immunized, a test for HBV antibody would probably be positive.  If so, you will know you are 100% protected.  In that case, you can safely have any and all sexual practices with your partner, without condoms for vaginal or anal sex.

1,4) Oral sex probably rarely transmits HBV, even with oral sores.  In the slight chance your immunization didn't work, condoms are highly protective.

Your last, unnumbered question also is important. Not all people with chronic HBV infection are highly infectious; and if your partner's hepatitis B surface antigen test (HBsAg) is only intermittently positive, it is likely her blood level of the virus is low and transmission risk might also be very low.  Also, she could have a test for hepatitis B e antigen (HBeAg); if that's negative, as it is in most chronically infected persons, then she is minimally infectious.

So here is my summary advice:  You and your partner should go together to the doctor or clinic where here HBV infection is managed.  You can have a test for HBV antibody to check whether you are protected from your immunization; and the doctor can also advise the two of you about sexual transmission risks.  Most likely you need not use condoms and can be confident you'll never catch HBV.

I hope this has helped.  Best wishes--  HHH, MD

[bthai44444]

Also,

She also sometimes tests postive for the HepB and sometimes test negative.  She tested postive in May and then negative in late August.  This has happened a couple times to her.  Is this even possible, seems very strange.

Thanks,