HIV-HBV-HCV risk

[nickcool]

Hi doc,

36 hours ago I was in a stipt club. I got a dance with a stripper. She scratched me a lot on my back, I saw some little blood on my shirt. My concern is whether there was some vaginal fluid at her nails or whether she has done the same to other men in the club so maybe there was some little blood at her nails. I didn't notice anything so we talk about tiny quantities. We had no sexual contact. I am 26 and I was vaccinated with all 3 doses of the hep b vaccine 19 years ago.
What do you believe about my risk of HIV-HBV-HCV? If you could talk we possibilities and percentages it would be very helpful. And what should I do? Am I fully protected against HBV with the hep vaccine 19 years ago?

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help and provide some perspective.  Your risk for getting any of the blood borne infections you mention is too low to accurately predict but is certainly less than a fraction of 1%.  The scenarios you describe have been repeatedly proven to not occur- that is the transfer of an infection on the from person to person through the mediation of another person’s, or their own, hands. The infections you mention are all rather uncommon making it unlikely that your dancer was infected, the organisms survive poorly in the environment and damaged organisms, even if not yet dead do not effectively cause infection.  Finally, for any of these infections to be transmitted requires them to be injected deep into tissue, deeper than is typically the case with scratches.

Your vaccination for hepatitis be will continue to protect you from acquisition of hepatitis B.  


My advice is to not worry about this scenario.  I see no medical reason for testing either.

I hope my comments are helpful to you. EWH

[nickcool]

Thanks a lot for your time doc!

[Edward W Hook, MD]

Hepatitis B is not a concern.  While the internet is sometimes a good place to learn about things, unfortunately, it is also a place were ideas being discussed can be amplified far out of proportion to reality.  Hepatitis B is not common and not nearly so infectious that you (or the internet suggest).  As I also mentioned, while viable, these organisms are very quickly damaged folowing exposure to the environment and as such are not infectious.  

The topic of the potential need for booster vaccination has been discussed for a number of years and is the subject of ongoing study however if it was really important, the need for it would have been proven at this time.  That is not the case.  I received my hepatitis B vaccination in 1983, before you were born, and work in a setting where I interact with persons with and at risk for all forms of hepatitis B on a regualr basis.  I have confidence in my vaccine status and see no need to worry about booster injections,  I suggest you do the same.  EWH

[nickcool]

Sorry for making so many questions. But I have read that HBV is very contagious and survive outside the body for days. So why can't it survive under the dancers nails?
I could say that I am not so worried about HIV or HCV but mostly for HBV.

Thanks a lot doc!!!!!

[nickcool]

thank you very much doc. You have relieved me a lot.

I am reading and reading all the time since that event searching the web. I have read that in my occasion booster dose of the vaccine is not proposed by the cdc guidelines. What's is your opinion? I think that I have to go to do a vaccine so that I feel safer.