Confused about transmission.

My boyfriend has symptoms of orangish urine, upset stomach, fatigue, and yellow skin/eyes.  He went to the dr and after blood tests the dr said it was probably liver related so they took more blood and he is scheduled for a cat scan.  Him and I had a vicious break up (unrelated to this) and are no longer speaking.  I hope everything is okay with him but am now kind of selfishly concerned for myself.  His symptoms sound like possible hepatits and was wondering if I need to be tested. Of course I'm sure it's always good to be tested.  We have had unprotected sex a few times and he swears he has not been with anyone else in over a year.  I have had oral sex with one other person. Neither one of us has ever used drugs. I have no symptoms but have read most people with hepatitis don't.  I'm kind of confused because some things I've read state that hepatitis is not sexually transmitted and other sites says it is.  Can you clear up any confusion I have and any advice would be appreciated.  Thanks

[H. Hunter Handsfield, M.D.]

You are right to be concerned.  There are many kinds of liver problems (and some non-liver) that could cause your boyfriend's symptoms, but viral hepatitis is the most likely overall.  Of the three kinds of viral hepatitis, types A and B are sexually transmitted; type C occasionally is sexually transmitted, but not usually.  (The mixed messages about sexual transmission often concern hepatitis C, perhaps explaining the different advice you have heard.) If your BF has A or B, you need to be checked immediately, and if not already infected, you can be protected by being vaccinated and perhaps by receiving other treatment (immune globulin).

Bottom line:  it is very important that you learn ASAP whether your BF has viral hepatitis and if so, which type.  His doctor should have those answers already, or certainly within the next couple of days.  Even if you can't get this information, see your own provider anyway.  He or she can then contact your BF's doc to learn what is going on.  Finally, if your own doc isn't up to speed on all this, contact your local health department for advice; or ask for referral to an infectious diseases or liver specialist.

Good luck--  HHH, MD

[virgogrl]

Thank you for the information.  We have not been sexually active since November so from what I have been reading it would be too late to get a vaccination.  From everything I have read it seems my risk of Hep C is low and the most likely thing he may have is Hep A which I believe would not be sexually transmitted, is that correct?  If Hep is easily identified by blood tests I'm wondering why the dr would have ordered a cat scan, this is so difficult since we are no longer speaking.  You are correct, the best thing would probably just to be to get myself tested for all 3 types.

[monkeyflower]

I'd think HBV would be more likely than HAV, but then I'm just guessing. As for your ex, I think the doctor probably ordered a CT scan because s/he's looking for signs of liver damage. The doctor might do an ultrasound to look for liver enlargement, etc., as well as a CT scan for more detailed info - like whether there were signs of cirrhosis, cancer, fatty liver, etc. Your ex's doctor may also order a liver biopsy at some point, too.

I definitely think you should go get tested, regardless of symptoms or timing.

[H. Hunter Handsfield, M.D.]

Monkeyflower is right; you still need to be tested if your boyfriend has viral hepatitis.  However, the scan could indicate they suspect a chronic problem, or perhaps biliary obstruction or some other non-infectious causes--in which case there is no concern for your health.  If in doubt, see your own provider.  Even if your ex can't clearly explain what's going on, or if his doc invokes privacy regs and won't talk with you, your own doc probably can get the needed information from his providers.

HHH, MD