Testing

[virgogrl]

Hi Dr, please don't yell at or delete me.  I did post a couple of days ago but I have a different question now.  About 2 weeks ago my on again off again boyfriend came down with what he thought was the flu, fever, nausea, upset stomach.  A few days later he had dark urine so he went to the dr.  The dr. took blood because he thought he had diabetes.  He then came down with jaundice. A few days later the dr. ruled out diabetes, took more blood and ordered a cat scan.  He did the cat scan and saw the specialist he was referred to who told him he didn't see anything abnormal in his blood except for high levels of DBile.  He told me he didn't have Hepatitis.  The cat scan shows nothing and the dr doesn't want to see him for another week in a half which I find very strange. Him and I haven't had sex for 2 months.  I've been patiently waiting to find out what is going on with him before I get tested for Hepatitis but now it seems he doesn't have it but I thought I would feel better getting tested anyway.  I'm worried I could have given it to him and it just isn't showing up in his blood yet.  My questions are 1. How long does it take for Hepatitis to show up in a blood test, is 2 months enough time?  2.  My only other sexual encounters have been me giving oral sex, is it likely that Hepatitis B can be transmitted only from oral sex? 3. Anything else I myself should test for?  4. Any ideas on where I can get tested?  I am in a major city and Planned Parenthood does not test for Hepatitis and either does the County Health Department.  I called my doctor and she insists on making an appointment and won't just let me get my blood tested.  She charges $110 for the visit plus the blood test and I have no insurance.  Any insight is appreciated.

[H. Hunter Handsfield, M.D.]

As Monkeyflower already implied, all in all this sounds pretty optimistic in terms of your own health risk.  If BF's doc says he doesn't have viral hepatitis, almost certainly you can rely on that.  I see no reason for you not to have sex with him, but you might double check with a direct question to his doctor. To reply to your specific questions:

1) Testing involves 3 viruses (HAV, HBV, HCV) and for each one there are 2-3 specific tests.  Some are positive within 1-2 weeks, others take 2-3 months.  But by 2 months they should be able to know (and it sounds like they do).

2) Oral sex hasn't been studied as a risk for HBV, but it is believe to be low risk.

3, 4) Since BF's doc has reassured him it isn't viral hepatitis, there is no particular hurry.  Many health departments have to prioritize such testing, since it is fairly expensive.  If you were a confirmed contact at risk, they might find a way to do it at no cost to you.

Anyway, it seems you don't have much to worry about.  Good luck--

HHH, MD

[monkeyflower]

While you wait for Dr. Handsfield's reply, I thought I might be able to help a little :-)

At first I couldn't quite grasp why you were waiting to be tested, but after reading the rest of your post I'm assuming the issue is money. I think it seems weird that the health department won't test for hepatitis. Hopefully Dr. Handsfield can give some insight as to why.

As for whether you may have given it to him, I think you can relax. I'm almost certain he wouldn't have those symptoms without having a positive result on a blood test, if hepatitis really were the cause.

Regarding the wait, well, it's my impression that as long as the symptoms and/or bloodwork and other tests show improvement, doctors seem to use a wait and see policy - at least for liver issues. I think this is because there are relatively few treatment options, and those treatments can be tough. And sometimes these things just resolve on their own. My husband has been experiencing liver issues too, and after an ultrasound, repeated bloodwork and a CT scan, his doctor has also elected to wait and see. It seems to have worked out, because in the last couple of weeks he has been feeling MUCH better. Hopefully your ex will too :-)

[virgogrl]

Thanks for your reply Monkeyflower.  Yes, it is a matter of cost, I can understand the dr wanting to see me before she authorizes a blood test but since I have no symptoms and am just doing it for peace of mind I thought she may be flexible,  I guess not!  Have you heard of www.areuatrisk.com?  They are in my area.  I don't know the pricing or if they are reputable, couldn't find much information online other than the actual website. I hope your husband is doing well.

[monkeyflower]

Thanks for the concern! I was pretty worried for a while, but he seems to be fine now. His liver enzymes were 10x what they should be, and he was nauseated all the time. It could be a chronic infection of HBV, or co-infection with HDV, or just a result of the statin he was taking. The latter is probably the case, because he's had HBV and has been fine for at least 18 years - and he's been feeling better and better since discontinuing the meds. But we'll find out soon; he has another appt Monday.

I hope things work out okay for your bf, and he feels better soon. :-)