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HCV Transmission
Dec 8, 2010

I am 29 year old Canadian male suffering from HCV transmission anxiety. To get infected by HCV, infected blood has to contact my bloodstream. Does that mean the blood has to hit a vein or artery? Or does the infected blood just have to somehow puncture my flesh sufficiently that it draws blood. How deep does the puncture have to be? Are skin contact with HCV blood as well as superficial scratches therefore considered negligible risk?

For any bloodstream exposure to HCV blood, is it very unlikely to acquire infection? Is it similar to the rate of 1.8% for a needle-stick exposure to HCV blood?

Is it considered zero risk or theoretical risk only ( i.e. no documented cases ) when getting punctured by a random surface, even one with blood? This is due to the low rate of HCV in Canada, roughly 2%, that HCV dies in the air by 4 days, and acquisition itself of infection by tainted blood is remote.

I know water kills HIV but does soap and water kill HCV? Or does it just wash it away. I wear contacts, is touching my eyes with potentially HCV infected hands a risk? How much should I wash my hands? When showering at the gym, I sometimes get splashed in the eye from water from another shower user, is that a risk?

Is it considered zero risk or theoretical risk only ( i.e. no documented cases ) when an existing cut or wound is exposed to HCV blood? How about for a heavy bleed? Does the fact that the body starts healing itself near instantly, sealing the wounds, even when exposed to water protect the body from HCV blood? Also don't we bleed outwards, protecting our wounds from outside fluid?

For example, while diving in Australia, I was bled on by a male diving instructor while getting geared up. This was after I was in the water already, so wounds may have been opened up by the water. The instructor's wound wasn't a gushing wound and I don't think I had any major gushing cuts. I did have some coral cuts and I have acne and body acne which produces open sores. However, during diving and showering, I didn't notice or feel any major cuts. I'm reasonably sure I didn't get any blood in my eyes or mouth. Am I in any danger?

Another similar situation would be touching HCV tainted blood and washing the blood into any existing cuts.

A man mentioned online he contracted HCV when fighting off a knife wielding assailant. They bled quite heavily into each other though. I am surprised there are not more warnings about sparring in martial arts or wrestling, which exposes many people to blood on blood contact.

How risky is household contact? For example, sharing razors, nail clippers, tooth brushes or scissors and electric razors for haircuts? The Doctor on Medhelp ( http://www.medhelp.org/posts/STDs/hep-c-risk-with-one-time-razor-cut/show/1025959 ) implies there is no risk and the CDC also downplays the risk. Regardless, I separated my personal care items but what about secondary contact. For example, I left my razor in the bathtub, what if someone splashes the razor with HCV blood or the razor touches the surface with HCV blood. Also, there is no warning about sharing toothpaste. The bristles of the toothbrush touch the toothpaste nozzle, won't that contact be a risk? How about rinsing a toothbrushes with the faucet, won't that contaminate the faucet with possible HCV blood? Sharing utensils are considered no risk, but can't people easily gouge themselves with a fork or knife?

At the Dentist office, I am confident they sterilize all the equipment. But what if they touch some HCV tainted random surface, and then contaminate an instrument, and that instrument breaks my flesh?

Is occult HCV something I should worry about?

Is a 3 months post exposure antibody test accurate enough and after 6 months a guarantee?

What's the reasonable amount of precautions I should take? Should I just resign myself to getting tested once a year? Should I just not worry about it since I'm not a IV drug user? My worse nightmare would be somehow infecting my girlfriend.

Response from Dr. McGovern

I cannot answer all your questions but the main issue is that - yes HCV is mainly transmitted with a blood to blood exposure among injection drug users and sometimes through sex that is associated with some minor trauma.

No I would not get tested yearly for HCV if you have not shared injection paraphernalia or have not had unprotected sex with someone with active HCV infection.

I agree that you have a great deal of anxiety about getting HCV infection. If all the scenarios of getting HCV that you speak about were true, basically 80% of the population would be infected...But the true number is 1.8%.

You should also speak to your physician about getting some counseling with a therapist regarding your phobia. This may be extremely helpful to you since more knowledge is not the answer. You know a lot about HCV but your anxiety is at a very high level which is not healthy for you.



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