I have a relative who has chronic Hep B and D, who happens to be my caretaker, as I am with cerebral palsy. And I would like to ask a couple of questions and ask for directions
I have heard that saliva is a potential carrier(but with very low risk), and as I use objects and touch everywhere so I can move(and after that touch my eyes, face, etc), and in addition, sometimes happen saliva to land on my eyes during conversation. Should I be worried or take some extra measures?
Is soap and water enough to disinfect surfaces and objects when blood accidentally lands there? If it is not, could you recommend something stronger?
Is it a good idea to have some immunoglobulin stored if blood a to-blood accident happens with some guest , neighbor etc?
(I am asking this particular question because I live in a small town in Eastern Europe, and let’s just say that the medical services often happen to be far from adequate)
I am Hep B vaccinated by birth with 3 doses, but that was 30 years ago, and my antibodies may have been worn off a little bit. Do I still have some sort of protection?
The viral load is 48.72942 UI/ml for Hepatitis B and 3100.47942 UI/ml for Hepatitis D. The gastroenterologist said that for now, medications are not needed, but I would like to ask if there is any alternative to the pegylated interferon.
Is one month enough time for HBsAg and anti-HBc total, and do I require emergency testing
It will be a long trip to get to a proper testing center, and is very hard for me to get there, so unless it is hardly recommended, I would like to leave the testing for a later time or skip it entirely.
Hi @StevenS,
Welcome to the community. I will try and answer some of your questions. First, there is no evidence that HBV is transmitted through saliva. HBV is a bloodborne virus so there have to be an infected blood and opening or wound to enter the other person. Mode of transmission for HBV is sexually, through the birthing process, blood transfusion with an infected blood and exposure to other bodily fluids such as sperms etc.
To clean blood, you can mix bleach with some water and use as a disinfectant on surfaces where there is blood. To your third question, I am not sure why you will need this since you have been fully vaccinated. I don’t think you need that. If you are exposed, you can get antivirals as post-exposure prophylaxis but I doubt you will need it because you are fully vaccinated. It will be hard to store such a product either way.
Your provider can check your antibody count or tithers to see where you are if that will make things easier for you to know. There are newer medications coming out for hepatitis D. I know some are already approved in Europe so you might want to have a conversation with the provider for your family member. I hope this is helpful. Bansah1
Hi @StevenS,
Thanks for sharing this article. The authors actually say this is plausible, but plausibility is not necessarily causation. Saying something is probable or reasonably does not mean it is the cause of an issue or something. Per the conclusion of their commentary they share that this mode of transmission is less likely to happen. Because in other for this to happen, there has to be blood in one person’s mouth and at the same time an opening or cut in the other person for the chance of transmission; hence the low risk. You are more likely to get it through sex and birth today than any other mode.
There have been some discussions here about this issue in the past, I hope you find this helpful: Are people around me safe?
Thanks again, @Bansah1. I have actually already read one of the articles you gave me 2-3 days ago.
I merely want to do what do what is best for me and my relative. Only I know English and can operate a computer in my household, and they rely on me and my answers. So from what you told me, I assume the risk is rather theoretical than practical
As one last thing, I would like to ask if there are any scientists or chemists to tell me (if possible) what are the names of the medications for hepatitis D and their relative prices, as I assume the governmental healthcare in my country will not cover these?
Sounds like you have a lot of responsibility providing such health information to your family. They are lucky to have you able to do that for them. Sure, I understand what you mean.
Hepcludex is the Hepatitis D medicine in Europe not approved for use in the US. Its usage seems much restricted. There is also peginterferon alpha 2. Given that your family member has both I don’t know if by treating the Hepatitis B will decrease their chances of severe liver disease. Hepatitis B and D together together increases the chance of severe liver problems such as cirrhosis or liver cancer.
Hopefully, there’s a cure for both viruses soon. Best, Bansah1.
Hi guys I was intimate with a girl and there was a little bit of intimacy and I kinda sucked her breasts…now idk what it is but i think i got a little fluid from the breast…it could or could not be…but this has put me into overthinking for std. Could anyone pls help me with the risks that i would get Hepatitis B from this pls.
I am the OP of the thread, and I have follow-up questions.
1, I got tested, and it turned out HbsAGnegative, but the anti-bodies level is only 0.5 UI/ml. So despite being vaccinated by birth, I may need the booster dose as well. Some say cellular immunity is enough though and I do not know what to think?
As I mentioned above, I have cerebral palsy, and my caretaker has Hep B + D. Yesterday, we finally managed to go to a lab. They drew blood from my wrist vein, where before that, my caretaker had held me in the same place. It was hot, and a lot of his sweat was on my wrists.
The viral load of B of my caretaker is low (48 UI/ml) that means the concentrations in the sweat will be lower.
Given that the needle goes directly into my vein, though, and the absence of antibodies worries me a little. So I would like to ask if some sort of liquid goes into my bloodstream, should I be worried?
I know that the quantity of sweat in my bloodstream will be exceedingly low. But how little is too little?
I am aware that I am a bit worried, but until I am revaccinated and given my current physical state, I do not want to add an additional problem to what I already have.
Thanks in advance for the answer and for the understanding
Hello. I took the liberty of having an AI calculate this for you in terms of probability. Note that the chance it calculated is far higher than it would be in reality, because it made some assumptions on the high side
It doesn’t really matter though because the answer is pretty much “impossible” either way:
To address the concerns and estimate the probability of Hepatitis B transmission under the given circumstances, we can break down the scenario into several components. Here’s the calculation framework:
Viral Load in Sweat:
The caretaker’s viral load is 48 IU/mL in blood.
Viral load in sweat is generally much lower than in blood. For simplicity, let’s assume the concentration in sweat is 1% of that in blood.
Hence, viral load in sweat = 0.48 IU/mL.
Volume of Sweat:
The amount of sweat transferred to the wrist could be assumed as a small droplet, approximately 0.01 mL.
Virus Quantity in Sweat Droplet:
Virus quantity = viral load in sweat * volume of sweat
( = 0.48 , \text{IU/mL} \times 0.01 , \text{mL} )
( = 0.0048 , \text{IU} )
Probability of Transmission:
Hepatitis B transmission through needle-stick injuries has a transmission probability of approximately 30% if the needle is contaminated with blood containing the virus.
However, sweat is much less infectious than blood, and the virus quantity is much lower.
Assuming a highly conservative estimate, let’s say the probability of transmission through this route is 0.1% of the probability for blood. Thus, transmission probability = 0.001 * 0.3 = 0.0003 (0.03%).
Actual Transmission Probability:
Since the amount of virus present in the sweat is only 0.0048 IU, we need to factor this into our probability.
If 1 IU of virus has a 0.0003 probability of causing infection, then 0.0048 IU has:
So, the probability of Hepatitis B transmission in this specific scenario is approximately 0.000144%, which is exceedingly low.
Considerations:
The actual probability might be even lower given additional factors like the integrity of the skin, immediate cleaning, and the body’s natural defenses.
For peace of mind and medical advice, consulting a healthcare professional is recommended. They can provide appropriate recommendations based on your medical history and current condition.
Now let’s calculate the probability that a single virion (a single virus particle) in the droplet of sweat, if it enters the patient’s bloodstream, would result in an infection.
Infection Probability per Virion:
The probability of a single virion causing an infection is extremely low. Based on general viral infection dynamics, not all virions are capable of establishing an infection.
For many viruses, the probability of a single virion causing an infection is often estimated to be less than 1 in 10,000,000 (or (10^{-7})).
Probability Calculation:
Using the probability (10^{-7}) (or 0.0000001) for a single virion causing an infection, we can directly use this for our calculation.
Therefore, the probability that a single virion in the droplet of sweat would result in an infection is (0.0000001) or 0.00001%.
To summarize:
If there was a single virion in the droplet of sweat, the probability of it resulting in an infection, given it enters the patient’s bloodstream, is about 0.0000001 or 0.00001%.
This translates to about 1 in 10,000,000.
In plain terms, it means the likelihood of that single virion causing an infection is about one in ten million, which is extraordinarily low.
Yeah, this is a reasonable approach at the question, but could have stopped at 0.01 mL of sweat and the concentration of 0.48 IU/mL: this would mean a drop of sweat is incredibly unlikely to even have a single virus in it. And you can’t transmit what isn’t there.
The original poster again. As I mentioned earlier due to circumstances I am in a process of waiting for Hep B vaccine.While waiting though something happened that bothers me.
I noticed today while my caretaker was cleaning up my feet in container with water, that there was a little scab wound on the wrist. It had contact with the 2L water, my feet were placed.It was 2-3 days wound.
The reason I am concerned is that I often tend to have between toes cracks and little wounds.The toes are too stiff with spasm due to my diagnosis.
The viral load of my care taker last measured was 48 IU ml for Hep B(inactive infection) and 3100 something for Hep D but the data is 5+ months old
Do I have to take some action, or all is ok?
The waiting for vaccine in my region is making me little nervous and angry.Excuse me if my question sound silly.
Hi @StevenS,
I just want to add if possible let your provider wear gloves if that will make you more comfortable. I have given a lot of baths in my past career and that can act as a barrier. Give it a try. Thanks, Bansah1
I want to ask a few more things. When we went to the hep B specialist, and he saw the results of the viral load, he did not prescribe any medications(only monitoring every six months), and when we asked about vaccinations, he said that “it is not necessary at the moment”, although all in the household are not vaccinated(we have a case of autoimmune disease, but this is a different subject), or with not enough antibodies (me).
I want to hear your opinion on that recommendation, as I find it a little risky.
Hello experts, please is this a good replacement for Vemlidy? Vemlidy has become too expensive for me and a pharmacist suggested I switch to Getinomide.
Also, I will appreciate if anyone who has tried it can share their experience with me.
Hi @StevenS
I agree with your doctor about not treating your caregiver at this point. The viral load is very low. I will recommend you all get vaccinated in the household. It’s impossible to know exactly when someone can get exposed, but being vaccinated takes that stress and worry away. Please, try and get your household vaccinated if possible. I will get the booster still if i were in your shoes. It can provide a robust protection and a solution to this issue. Best, Bansah1
