STDs Expert Forum
Hepatitis B Anxiety
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Hepatitis B Anxiety

Hi there. Here is some info about my concerns:I've had multiple sexual partners, but have only had unprotected sex with two men in my life. One was my first boyfriend, and we were both virgins. We used condoms but there were a couple of times that we didn't. He never ejaculated inside of me. When I was 18, I started dating a guy, and we had unprotected sex twice, he never ejaculated in me. I did contract genital HSV1 from this relationship, he performed oral sex on me while he had a coldsore.
A year ago, I was in a relationship with a man for a  few months. Before we engaged in any sexual activity, he did assure me multiple times (yes, I know, it's the OCD that makes me ask over and over and over) that he did not have any STDs. We never have vaginal sex, only oral. He did try to have unprotected anal sex with me, but I stopped it as soon as I knew what was going on. I don't think he even fully penetrated me.

Now I'm completely paranoid that I could have Hepatitis B and don't know it. The worst thing I can do at this point is run to the doctor and get tested, because that would do nothing to help my OCD and I would move on to another disease almost immediately after getting test results.

I just received my first round of the Hep B vaccination last Monday. I've spoken with my family doctor about my concerns, and he has told me that he doesn't see anything to worry about. He's been my doctor since I was born, and I have bloodwork done every year at my routine physical. He always checks my liver enzymes due to the fact that my dad does have liver disease. My bloodwork has always been normal, never any fluctuations or cause for concern.

I guess my questions are:

1.) Do you see any need, other than to ease my anxiety, for me to get tested for this?
2.) What is the rate of trasmission for Hepatitis B?
3.) Would fluctuations in my bloodwork be a sign that something is wrong? And does what my doctor is telling me sound valid and logical to you?
Thank you.
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

You have had a virtually zero risk lifestyle with respect to sexually acquired hepaitis B virus (HBV).  Your personal physician is exactly right:  there is no cause for worry.  It is statistically unlikely either of your unprotected sex partners had it, and your normal liver function tests are further strong evidence against it.  Also, although HBV is officially listed as an STD, it is far less readily sexually transmitted (among heterosexual men and women) than most other STDs like chlamydia, gonorrhea, herpes, etc.  In the US and other industrialized countries, it's quite uncommon as an STD, especially in people with sexual lifestyles like yours.

Having said all that, you could of course have a blood test that would tell for sure whether or not you have ever been infected with HBV.  The tests are inexpensive and readily available, and you may find that the specific test results are more reassuring than all the theoretical analyses your doctor or I can provide.  You could discuss it with your doctor.

Finally, you can consider HBV immunization.  All people are supposed to be vaccinated, regardless of sexual or other risks.  Then you'd never have to worry about it again.

Those comments pretty well cover your specific questions, but so there's no misunderstanding:  1) Anxiety relief is the only indication for testing -- but that doesn't necessarily make it unimportant.  Anxiety relief is good!  2)  I can't tell you a numerical risk -- but it's exceedingly low.  I've never seen anyone with your sexual lifestyle who had sexually acquired HBV.  3) Minor blood test fluctuations are entirley normal.  I agree with your doctor.

I hope this has helped.  Best wishes--  HHH, MD
7 Comments
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Oops, I meant to mention that the one occurance was 8 years ago, ... Wouldn't I have some sort of symptom or sign in 8 years?
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239123_tn?1267651214
Absence of symptoms doesn't mean anything one way or the other.  Most HBV infections are entirely asymptomatic.
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Thank you so much for the speedy reply, this site is doing a great service to those of us who choose to seek its help. I do suffer from OCD, so it's just hard for me to be able to separate a real risk from the ones I create in my mind. I trust my doctor entirely, and just wanted someone else's opinion. As for getting vaccinated, my first round of the hep b shot was last monday :) I go back in a month for round two. My yearly physical is in June, I may just ask for a full std work up, it's not a terrible idea. But for now, I will try my hardest to just live life. :)
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Just to be clear, the incomplete act of anal intercourse (probably less than 15 seconds) very minor penetration if any at all, isn't a factor here?
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239123_tn?1267651214
Nope.

As you say yourself, a hallmark of OCD is the disconnect between intellectual understanding and emotional acceptance, combined with a tendency to overthink the situaiton and come up with any number of scenarios along the lines of "what if", "yes but", "will I be the exception", and so on.  When this happens to you, my request is that you ignore such thoughts and not ask about them here.  Trust me on this:  there is nothing that will come to mind that would possibly make a difference in my opinion or advice.

Best wishes.
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You're so right. When I give the thoughts power it makes it so much worse for me. Thank you for helping me to see that my problem is OCD, not an STD. You're the best! :)
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