years later - should i test again?

[scaredstupid]

I did post a question back in 2006 regarding fear I was infected with either genital herpes or HIV based on unprotected oral sex and protected (condom) with an Asian female at massage shop, in combination with symptoms I had at the time (small sore on scrotum, feeling of malaise and loss of appetite, slight feever a couple weeks after exposure. Almost exactly 12 weeks after exposure I asked my doctor for a full STD screen of my blood. I never got he results letter because it was mailed to an old address on my insurance record, so I called and the doc said simply all tests were neg... Although I have always been haunted by this experience, and when I have a weird symptom I think back to this and wonder. So one day I actually pulled the record of the results and found that I was only tested for HIV, HSV2, and one version of hepatitis, can't remember which but I want to say I researched online and found it wasn't one that was an STD... But, I still felt like maybe this was behind me and I could go back to my life, until now, I took a routine physical and my doc wants to have additional testing regarding a "slight" issue he sees with my liver and other stuff. Well I googled those symptoms and found chronic hepatitis a possible cause. Now, I am obviously worried. I really want to put my STD concerns at rest here, what are ALL the STDs I need to be screened for based on this exposure, and what is your professional opinion at this point in my case on whether I could have hepatitis of some kind, and if I do have hepatitis still from this, what is the prognosis, and finally, if there was a chance of infection of hepatitis or something else, why didn't you recommend I test for it at that time?

[Edward W Hook, MD]

This will be your last answer as my reassurrances do not seem to be registering on you anyway.  Yes, a 12 week, negative test for hepatitis rules out hepatitis B acquired in the past.  

The thread is over.  There will be no further answers.  Work with your doctor on this.  EWH

[scaredstupid]

I understand, I do just want to rule out STDs first, so I can stop kicking myself for making a reckless decision that could have devastating effects on my life years down the road. It was the worst decision, in fact, I have ever made. Assuming the Hepatitis test taken 12 weeks after exposure was Hep B, is that long enough to be conclusively negative? Would you even recommend I re-test for HIV or anything else?

Prior to, and since this exposure, I have been in completely monogamous relationships which I would rate as extremely low risk.

[Edward W Hook, MD]

A bilirubin this high needs to be evaluated but the list of possible causes is very, very long and in your case, STDs should not be high on such a list. I don't mean to "brush you off" but our answers on the Forum are restricted to dealing with issues related to possible STDs.  EWH

[scaredstupid]

I should also add I was fasting for 12 hrs leading up to the physical. Do you have any thoughts that might give me comfort while I await more tests?

[scaredstupid]

Thanks doc. I really wish I could be as care free as you suggest. The cause of the abnormal test result was high bilirubin (3.0 on a scale of 0.3-1.3). I had a sore throat and a urine test showed I was dehydrated. Any chance I am normal after all and these test results could fluctuate even in a healthy person? I have not had any pain of significance, nor any other evidence of a liver problem. But I am extremely stressed out to think I could have chronic disease.

[Edward W Hook, MD]

Welcome back to the Forum.  Sorry to hear of your lingering concerns of this long past exposure.  The only form of hepatitis regularly transmitted through genital  sex is hepatitis B and that is not common.  hepatitis C is rarely transmitted in the course fo rectal intercourse and thus is not relevant to you and hepatitis A is transmitted through ingestion of fecal material which again can sometimes occur in the context of sexual activity between men who have se with men but does not sound to be a relevant concern to you.  On the other hand, there is a long, long list of other things that cause abnormalities of liver tests including obesity, gall stones and other systemic disease.  

My recommendation is to not worry.  I suspect your doctor will do the appropriate tests on you.  should you have chronic viral hepatitis which I suspect is most unlikely, then we can address where the infection might have come from.

I hope my comment provides you with a bit of peace of mind.  EWH