Hep A, B and C from mutual masturbation, anal massage and contaminated massage table

[hr_help]

Dear Dr. Hook/Handsfield,

I am very concerned about the possibility of contracting hep a, b and c (I am not vaccinated for a & b) from my exposure (I tested negative for HIV at 6 weeks). I am 37 years old and located in Toronto. I was negative for hep a, b and c in 2008. I was suppose to get a vaccine for a and b but I keep forgetting. I was married the past few years so did not need to get the vaccine for b since I was in a permanent relationship but that did not work out. Otherwise, I do not have an active sex life - this parlor episode was the first sexual exposure in 2 years.

My exposure was in late November 2012:

-mutual masturbation at parlor with Chinese attendant in her 40s (high chance of hepb)
-she was masturbating me but I did touch her vagina few times and felt her moisture. I also touched her anal area by mistake.
-She masturbated me for quite some time, on and off in between giving me a massage.
-She also massaged my anus with baby oil for 1-2 minutes.
-I remember I touched the head of my penis with the hand that I used to touch/massage her vagina.
-I had an appointment after so I did not shower there and waited to shower that evening.

My concern is that I may have caught hep a, b or c given this exposure because of my symptoms.

-yellow-ish loose stools
-nausea for most of the day
-fatigue (but not currently - my exposure was in late November and I felt severe fatigue with all the other symptoms in early January 2013).
-massive acid reflex
-stomach makes all sorts of noises
-bloated and *LOTS* of gas
-canker sores - i have had 2 episodes of canker sores since December 2012 where I got 2 each time.
-discomfort and slight pains in the area under my right rib (where the liver is located)
-I wake up during REM sleep almost every night like around 4am and then can't fall back to sleep.

I am concerned that the massage of my anus and penis for hep.

I appreciate your help doctor.

[Edward W Hook, MD]

g;ad to help.  EWH

[hr_help]

Dr. Hook, well you are right on! My HBV and HCV were negative (she did antibody and various antigen tests to test for HBV). I do have HAV anitbodies, which I think might be related to the fact that I think I had one shot of the vaccine in 2008 (not sure if there are multiple shots). Its a bit fuzzy as I was going to travel to Thailand and I went for an appointment but can't remember what injections I got. I was suppose to get the 2 shots for HBV vaccine but I think I only got 1 shot and then I missed the second appointment due to work travel and forgot to re-do. So I'm not vaccinated for HBV.

In any case, she also tested for celiac antibody, which was negative so thats good news. She did say that my liver tests (AST) was mildly elevated and the ALT was normal. She wants to recheck in 2 weeks but suspects that they will be normal then. I'm in good hands with this doctor as she is very thorough and takes the time to discuss and explain things to me.

Once again I thank you for your help and truly appreciate the wonderful work you and Dr. Handsfield do here. Keep up the great job!

[Edward W Hook, MD]

Great.  I am confident the tests will be negative.  I hope that your doctor will be able to help you with your symptoms. EWH

[hr_help]

Thank you Dr. Hook. I appreciate your assessment. I have an appointment with my primary doctor this Thursday and will ask for hep testing and her guidance. Thank you very much.

[Edward W Hook, MD]

Welcome to the Forum.  In preparing to comment on your concerns, I reviewed your other 17 posts on our community site before this one and agree with much of what was said there.  Of the various forms of hepatitis, the only one which is sexually transmitted with any meaningful frequency between adults is hepatitis B and that is not transmitted all that often. Hepatitis A is transmitted through ingestion (swallowing) of material (usually food) contaminated with stool from an infected person and hepatitis C is transmitted through transfer of blood deep into tissue (sexual transmission does rarely occur in persons with receptive rectal intercourse  but that is not relevant to you).  That leaves hepatitis B. to my knowledge there has NEVER been a case of hepatitis B or any other form of hepatitis transmitted through receipt of masturbation or through transfer of infected material from one person to another one someone's hands.  Your circumcision status makes no difference.  

Further, your symptoms could be due to any number of gastrointestinal processes and are unlikely to be hepatitis.  

I am quite doubtful that this is hepatitis of any sort, much less hepatitis that you acquired through the sexual encounter you describe.  You have been expressing concern about this on our site now however for over a month.  I advise you to go and be seen by a physician.  He/she may choose to carry out hepatitis testing and if your problems are due to hepatitis, the tests will be positive.  On the other hand, if tests are negative, you should look for another cause.  I am confident that your tests will be negative.  

I hope my assessment and comments are helpful to you. EWH

[hr_help]

Dear Doctor,

I also forgot to mention that I am also burping/belching a lot - all day, everyday. Its related to the GI symptons of acid reflex, gas, bloating and yellow-ish loose stools.

Thank you.