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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Curious about gonorrhea and HepC co-transmission
Apr 11, 2002

I have read a lot of your answers on this page, and have deducted a couple of contradictory statements. I therefore will ask for your help in clarifying the issue:

1. Blood is the only issue in transmission of HepC. I.e. If you are contracting HepC via sexual activity, blood from your partner has somehow reached your own blood stream (?).

2. Sexual transmission rate is very low, unless there is another venereal disease already present in, or co-transmitted to, the contractor.

My case: After having unprotected receiving oral intercourse, I contracted gonorhhea (no chance of other mode of transmission and also found that the actual female partner was diagnosed with exact same strain of diplocchia). Now, 2,5 months later, I've started getting syptoms like pruritus all-over, right side aches (liver-area and shoulder), rash - especially on forehead - that is very persistent, muscle and joint aches, slight malaise and fatigue. No jaundice or discolored urin/fecies.

I have read statements by a very experienced GP with mostly HIV-patients that receiving oral sex has never to date been documented as mode of HIV-transmission, whereas giving oral sex (especially on males) have been. The reasoning that has ensued from this observation points to saliva being a highly effective detterant of HIV, meaning spit alone won't transmit it (whereas sex-related secretions as semen certainly does). It seems to me this is not the same with Hep C, as some experts on Hep C states it can - although extremely seldomly - be transmitted by random kissing. Your take on this ?

And as to the initial issue, and bearing in mind that I do not know whether my female partner has Hep C -and do not want to ask - but know she is in an indicated group: Presuming that no blood cells of hers made contact with my blood stream via this unprotected episode of oral sex, would the transmission of diplococchia indicate I had a risk even still ? If so how ? (Pondering the chain of causation). Note: I was effectively spectinomycin-treated for gonorrhea within three weeks of said episode, and had in the meantime experience no - or very little - discharge visibly containing blood (slightly unsure whether it was a bit red once).

I will of course go and get tested, but my mind is working a little bit on this now due to the presenting symptoms, and after reading possibly contradictory statements on your part, as sketched out above.

Response from Dr. Dieterich

Hepatitis C is very unlikely to be transmittted sexually. There are no receptors for HCV except in the liver so blood to blood or blood to secretions contact is necessary for transmission. There is no such thing as completely safe sex except with yourself. You are doing the right thing, get tested and stop worrying, the chances are vanishingly small! DTD

HBV core antigen
unable to take meds more than a few months

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