Hepatitis Transmission Question

[wtwall]

Doctor,

This is a somewhat delayed follow up question from other questions I've asked in the HIV forum.  I was curious as to whether any variant of hepatitis, especially hep-b, could be transmitted by deep/french kissing, especially if there are canker sores present?  Some sites say yes, some sites say no, some sites say there's a maybe chance, etc.

I am not vaccinated and plan on starting the series this Monday.  I actually never gave it serious thought because my exposures have been such low risk, and I'm worried that may have been in grave error.

Also, my prior exposures run the gambit -- I've given oral sex, but it's been a very long time.  I received oral sex recently with a CSW.  Mostly, my exposures are isolated to mutual masturbation and kissing, sometimes with CSWs and sometimes not.  I'm going to get vaccinated either way, but is there anything I need to be doing preventatively in the meantime?  Should I get tested?  Prior to vaccination, during, after?

In addition, when does the vaccine take effect?  After the first shot or after the entire series?

Thanks so much for your help

[Edward W Hook, MD]

No.  EWH

[wtwall]

Sorry about the delayed follow-up.  I mentioned that I'd given oral sex some time ago and received oral sex recently.  Would either of those exposures warrant testing?  

I got my first vaccination today.

[Edward W Hook, MD]

The only variant of hepatitis which might be transmitted through kissing is hepatitis B. Hepatitis A and C are not a consideration. The risk of getting hepatitis B from French kissing is close to zero, even if you had a canker sore present. The reasons for this are not only that this is an inefficient means of transmission but also the fact that active hepatitis B is a very, very rare infection, even in commercial sex workers.  I would not recommend testing.

As for vaccination, there is some protection following the first injection, more (nearly complete) after the second and then, of course, maximal protection following the final infection. Vaccination is a good idea, not because the risk if very high but because the vaccine is safe, effective and has already helped to reduce US hepatitis B rates in the direction of eliminating it completely.

Hope this helps.  EWH