Hep B

[Geoffs33]

Hi Doctors,
I'm a married heterosexual male. I recently stupidly strayed when i was in a strip club and drunk, I performed cunnilingus on and fingered one of the girls. I knew I wasn't at risk but tested anyway and was negative for everything but Hep B which i wasn't tested for. I've read various posts from you which state that cunnilingus and fingering are not a risk for hep b and are not a cause for concern. My two questions then, which are really just to put my mind at ease as my over-riding worry is any risk that I may have put my wife at from having unprotected sex with her since this incident:

1) I'm absolutely not challenging your advice about fingering and no risk, I'm clearly just missing something obvious but i'm just confused by something I've read on the WHO website that states that Hep B is one of the few infections that can live outside the body for up to 7 days. I'm really concerned that i may have got hep b on my fingers (i had a fresh, small open cut on one of my fingers - i know from various posts on this site that this is of no concern) and passed it to my partner the following day when i masterbated her. I really can't remember if I'd showered or not the following day before sleeping with my partner. Is this a realistic risk?

2) Both of you have said on numerous occasions that Hep B isn't known to be transmitted by cunnilingus and that there is no need for testing. I've also read that Hep B isn't as well researched as say HIV. I just wanted to check that in your professional opinion (which i obviously respect greatly) you feel that there is enough research been done to say with confidence that that no testing is necessary & I've read things correctly, it isn't a case of "given the limited research available my view is that no testing is necessary."

3) Do you think that I can put this worry behind me and continue unprotected sex with my wife with no fear of having put her at risk?

Thanks Doctor

[Geoffs33]

Thanks for this clarification. Anxiety getting the better of me. Thanks again and enjoy the rest of your weekend.

[Edward W Hook, MD]

None of this additonal information, nor does your "could it..." question change my opinion or recommendation in any way.  I urge you to stop worrying and more forward.  You concerns are likely more of a manifestation of your guilt over the events you have described than any meaningful risk.  EWH

[Geoffs33]

Apolgies, I should have included above. Given that hep b can live outside the body would you think there was any risk from any infected virginal secretions I had on my fingers being transferred to my penis shaft and he tip / opening to my urethra when I urinated inmediatedly afterward. These sites would obviously not enable infection to be rubbed off? It would be really appreciated if you could respond to these final questions doctor, just so my mind is fully at ease. Thank you again.

[Geoffs33]

Sorry Doctor, I realised last night that any vaginal exertion containing hep would of course get on the top of my finger (finger nail side) and so this part of your finger rarely actually touches anything, unlike the under side. I also had this small open cut on the finger nail side of my finger which could have given the warm and moist surface you mention. I just wanted to check that your advice would not change and that you would still not see this as a risk of hel b transmission to my wife. (I had been outdoors etc so my finger would have been espoused to air, I don't know if this would make the chances of the infection living any less).
Thanks doctor

[Edward W Hook, MD]

Glad to help. Take care.  EWH

[Geoffs33]

Thank you doctor. This has certainly allayed my fears. It's good to have a voice of reason in the world somewhere online! All the best.

[Edward W Hook, MD]

Welcome to the Forum.  We get many questions about hepatitis B as an STD, far more than the magnitude of the problem warrant.  As you point out, the risk of anyone getting hepatitis B through sexual activity in North America is quite low. The disease is rare and becoming rarer as ongoing campaigns to promote hepatitis vaccination are proceeding with great success.  At present the main population for who hepatitis B is a realistic concern is men who have sex with men.  In all other instances the infection is quite rare - so rare that exhaustive detailed studies are difficult to do.  Have said this, let's address your questions.

1.  Under optimal. warm, moist conditions I suppose hepatitis B might stay alive outside of the body for days but this is the exception not the usual case.  For you, had the stripper had transmissible hepatitis B (unlikely) if contaminated vaginal secretions had gotten on your fingers, they would not stay there long.  The hands and fingers touch far too many other surfaces that the virus could rub onto (and off of your fingers) to be a concern.  That you got hepatitis B virus on your finger, that it remained there until the following day and then could have been transmitted to your partner through masturbation is inconceivable and should not worry you.

2.  I have personally searched the medical and scientific literature for cases of hepatitis B transmitted through oral sex an found none, nor have I ever seen a case.

3.  Yes, I feel you can certainly have sex with your wife without concern about having gotten and transmitted hepatitis B through the activities you describe above.  Please do not worry further and there is no need for testing.  EWH