Possible HCV exposure through sex
May 8, 2014
Hi doctor, I am a female and 2 weeks ago I had a 30 second episode of unprotected vaginal sex with someone who is very high risk for HCV (multiple sex partners, tattoos, past drug use,etc). I later noticed he had a small lesion on his penis and now, exactly 2 weeks later started experiencing severe nausea, ruq pain, and bloated stomach. The pain does not go away and feels more like rib pressure. I also have a bad taste in my mouth. Questions: 1) how risky was this exposure and do my symptoms indicate that I have acquired hep c? 2) what can I do now at slightly over 2 weeks post exposure - I know the antibodies will not be present but what about liver enzymes? I heard they also take a good 6-8 weeks to rise but if I'm experiencing symptoms this early on would the enzymes be elevated by this time or should I wait?
Response from Dr. Taylor
This is a low risk exposure but given how you are feeling I would talk with your doctor and get blood tests for ALT, AST, Tbili and HCV RNA, the virus itself. Also talk with your doctor about testing for other sexually transmitted infections such as HIV, hepatitis B and syphilis.
In general, hep C is NOT passed through heterosexual sex, sex between a man and a woman. However hep C may be spread through sex involving blood, and seems to be spread via sex more often when an HIV-infected man has unprotected anal intercourse (sex in the butt) with another HIV-infected man. Anal intercourse in general involves bleeding even when we do not see blood, so is considered higher risk for hep C spread than when the penis goes in the vagina (vaginal intercourse)....no matter men having anal sex with men, or men having anal sex with women. If the vaginal intercourse is rough such as with rougher consensual sex or sexual assault, there is more concern for hep C spread, but still overall the data we have thus far do not point to high rates of hep C spread via sex other than between HIV-positive men who have sex with men.
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