Can This Stomach Pain/Discomfort Be HCV Or Some Other STD?

[feanorius]

Dr. Handsfeld or Dr. Hook,

I went to a female escort about 5 weeks ago and I had protected oral and vaginal sex while I was wearing boxers (yes, a little too cautious) and engaged in a lot of deep kissing. I brushed my teeth and used listerine before which I know not to do anymore and after brushing my teeth I turned off the sink using the top-side of my finger where there was a small open cut/wound that wasn't bleeding but was still red and maybe in the beginning stages of scabbing. I have been vaccinated for Hep A and B already. At around the 3 week mark, while I was eating I developed this bloating feeling especially in the upper abdomen area where it seemed like my stomach was expanding too much. And now I've been having these on and off again upper abdominal pain (tight, knot-like sensations) and general discomfort, tightness and bloating especially after I eat. I don't know if I saw some website about Hepatitis C and then assumed that my liver was being affected which is causing me this abdominal pain and bloating, but I don't think I did at least before the 3 week mark. Questions:

1) Would there have to be HCV-contaminated blood on the sink handle for me to acquire HCV if I touched it with an open cut on my finger? If there was and I immediately washed my hands am I ok? I'm worried about all the people that could have used the escort's bathroom that might have had HCV and it remained on there even w/o blood being present.

2) Reading my scenario, realistically, what is the risk of actually acquiring HCV?

3) This upper abdominal pain/discomfort and bloating is perplexing. I've never had this problem before but when I do have stress or anxiety I usually have lower, middle abdomen discomfort causing diarrhea. Having said that could I be overreacting and this all be caused by stress/anxiety?

4) Can I get a HCV antibody test at around the 6 week mark and if it comes out negative would that be a relatively good indicator that I don't have it?

Thank You

[Edward W Hook, MD]

Still zero risk.  Hepatitis C is almost never transmitted sexually or by kissing.   EWH

[feanorius]

Dr. Hook,
    Thank you for your prompt reply. Even if the escort did have Hepatitis C would I still be virtually zero risk for deep kissing and protected oral and vaginal sex? I just don't know what to think about my abdominal pain, tightness and bloating symptoms since all of this has happened since the escort encounter, and I've read on the hepatitis c forum that liver inflammation from hepatitis could cause other areas of the abdomen to stretch causing the abdominal pain. So putting two and two together I automatically think I have HCV since it doesn't seem to be closely related to anything else although I don't rule out stress/anxiety. But can the mind really cause all these abdominal pains and even the upper abdomen feeling expanded sensation? I think I just need assurance and convincing from you that all my symptoms can be caused by my mind/anxiety/stress especially since you've seen so many suspected hepatitis and std cases with symptoms similar to mine that turned out to be nothing at all.

Thank You for your time

[Edward W Hook, MD]

Your risk from the exposure you describe is very low.  For starters, you do not know that your partner had hepatitis C and unless she was an IV drug user, chances are quite low that she or recent prior clients  did.  In addition, the idea that you would become infected due to exposure to tiny amounts of blood present on the sink knob through a cut on your hand which had already begun to heal (healing starts within hours of the occurrence of a cut).  As for your questions:

1.  No, without visible blood there is virtually no risk.  If there were we would have lots of infections occurring within households and from public restrooms and neither occurs.
2.  Zero from the exposure you describe
3.  Anxiety could be a contributor. There are no STDs that would explain these symptoms.  If they persist, I would seek the advice of a health care professional.
4.  Given your exposure history, getting tested for hepatitis C related to this exposure would be a waste of time

Hope this helps. You are not at risk and do not need testing.  EWH