I Bit and Got a Bite

[Jhon33]

I had a fight with a person who has had a tuberculosis and now he's going through medication .This means that he has tuberculosis, but it's not transmitted because it's controlled because of the medication .I don't know if this person has HIV or not , but as I understand that tuberculosis happens because of HIV. This person is very thin , and unclean. This person had sex with many people , and I know for sure that he doesn't know about his HIV statues, and he might have done many unprotected sex. Many people who know him has advised me to go through testing . He wanted to attack me , and that I held his hands. When I was holding him , he bit me on my arm where it bled , and it left a green and bloody area . Right after this bite, I unhold him  and that he attacked me by putting his hand in my mouth and he was grabbing my mouth and it was painful. His grab was getting harder whenever I tried to get his hands off my mouth . After that , I bit his hand , which was in my mouth , and after the bite he got his hands off my mouth. He got a small cut (wound) in his middle finger because of my bite , and that I believe his blood was in my mouth. It was very small wound ( I realized this later).  Also, His hand caused a cut in my mouth. After that I directly took shower , and I cleaned the bite in my arm with alcohol . I'm really concerned about it , and I feel that the risk is so  high .After the fight in three days , I had an open sore on my lip , just in the area where he was grabbing my mouth. I'm sure that testing is necessary , but how can I wait three months . Please doctor , can you tell me what's the real risk about this situation? I bit and got a bite … It cannot be more risky than this . I know the risk all in me biting him , not in his bite on my arm . It was blood to blood contact and I had a small wound in my mouth , though the amount of blood wasn't a lot. I'm not only scared from HIV , I'm scared from all STDs .

[Jhon33]

Thank you doctor for your help .

[H. Hunter Handsfield, M.D.]

6 weeks would be fine for syphilis and probably OK for HIV as well.  Some experts continue to recommend 3 months for HIV testing, so you could wait until then if you wish.  But with modern HIV antibody tests, almost all newly infected people are positive by 6 weeks.

[Jhon33]

Thank You so much doctor.

How many weeks should I wait to get tests for HIV and syphilis?

I'm sure 100% that he has TB.

Again , thank you so much. Your answer is really a relievement.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV prevention forum.

You received accurate advice on the community forum.  Although biting is often listed as a possible risk for HIV transmission, because of a theoretical risk from tissue injury and blood exposure, to my knowledge no HIV infections have ever been attributed to either biting or being bitten.  If it has ever happened, it is extraordinarily rare.

Further, your fighting partner doesn't necessarily have HIV.  (It doesn't even seem certain he has TB, but we will assume he does.)  Although it is true that TB is more common in people with HIV than without it, in most countries around the world, the large majority of people with TB do not have HIV.  

There are no data on transmission of other STDs by biting, but undoubtedly this is just as rare as for HIV.  I can imagine small risks for HSV-1 (which isn't considered an STD when it involves the mouth) and syphilis, but in 30+ years in a busy STD clinic, I have never seen an STD that was acquired either by biting or being bitten.

So there are no STD/HIV risks.  For peace of mind, perhaps you should be tested in a few weeks for HIV and syphilis.  You can expect negative results.  In the meantime, be on the lookout for signs of infection involving your bite wounds -- i.e. pus, redness, soreness, a red streak running up the arm, a swollen/tender lymph node in the armpit, and fever.  Such infections are due to standard bacteria on the skin or in the biter's mouth, not due to STDs -- but they can be quite serious and you need to see a health care provider immediately if any of these symptoms show up.

Let's not get into a string of follow-up comments or questions as on the community forum -- where you had to be warned about excessive anxiety-driven questions.  There is no information you can provide that is likely to change my opinion or advice.

I hope this helps.  Best wishes-- HHH, MD