How likely is a sexual transmission with a viral load of 65UI/ml and using a condom?

Living With Hep B Hep B Transmission and Prevention
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Hello HepB Community,

what a wonderful community this is really. I’ve been looking for an online support for some time now and am very much happy that there is a space like this one :slight_smile:

I have been diagnosed with chronic Hepatitis B and I have it since birth. It now has been almost 7 years that I take antiviral pills that suppress my viral load to a minimum.

For some time now I consider entering the dating space with my Hepatitis B and I want to learn disclosing my status as well.

One thing I’ve been wondering about is how to protect my sexual partners best that are not vaccinated.
We have protected vaginal sex by using a condom, unprotected oral sex and I have a viral load of 65UI/ml. I am a woman.

I will definitely counsel a doctor this coming week.

But what is your take on this?
Thank you :slight_smile:

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Dear Linda,

Glad that you have found this community as well!

Regarding your question, your low viral load lowers the transmission risk significantly, as well as using a condom.

Transmission can still occur through oral sex, particularly when you are menstruating, so dental dams are recommended. However, I do realise that these have a bit of a marketing and availability problem - see https://www.glamour.com/story/what-happened-to-the-dental-dam, I don’t know if things have improved. I did find out though that you can make them out of condoms - https://www.cdc.gov/condomeffectiveness/Dental-dam-use.html.

Of course, the best protection would be for your partners to be vaccinated.

Perhaps some @HealthExperts could weigh in here to talk about some things I may have missed.

Hope this helps.

Cheers,
Thomas

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Hi Linda,
I am an Infectious Diseases specialist and treat patients with Hepatitis B. I agree with Thomas’s comments. With your low viral load the risk of transmissions is low but not zero, so for any partners who are not vaccinated then using barrier contraception is the safest option.

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Hi Lynda,

I am a senior HBV Virologist. Mark and Thomas are right. Low titers reduce risk but do not eliminate it.

The HBV vaccine is very safe and effective in ~93-95% of people. There are a few variations of the vaccine out there, but they are all essentially equivalent. They typically are a 3 shot series, with the second shot 1 month after the first, and the 3rd one 6 months after the first shot. Measuring HBsAg antibodies through a simple blood test after the vaccination series is complete will tell you whether it worked. I strongly encourage everyone to get the vaccine!

John

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So having unprotected sex after becoming completely vaccinated and having immune titer won’t get you infected if i am having sex with my hbs ag positive partner right

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It is unlikely that there will be any transmission if you have protective levels of antibody in this case.

Thomas