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Confused.
May 14, 2003

Dear Doctor,

I just want to ask you about my case posted on 10 May 2003.

You said that I am unlikely to contact STD. Well that is good news to me.

However you did mentioned that kissing is a risk for the spread of Hepatistis, I therefore would like to know how risky? ( Isn't saliva known to kill HIV because saliva contains a protien to kill HIV? So my next question is will saliva kill this Hepatistis virus?)

Also women had been known to spread HIV or AIDS to their babies? So I will like to know does nipple sucking spread HIV or AIDS?

Thanks doctor for your time and answer.

Response from Mr. Kull

Yes, let me clarify. You should not be concerned about HBV infection during kissing, although risk for infection is not absent. The same does not apply for HIV (they are two different viruses that are transmitted in similar and different ways).

You are at greatest risk for hepatitis B infection when coming into contact with an infected person's blood; the highest levels of hepatitis B virus (HBV) in an infected person's bodily fluids are found in blood. This most commonly occurs when sharing needles.

Lower titres of HBV are present in semen and vaginal secretions, so transmission through sexual routes is possible (through anal, vaginal, or oral sex). There is varying information on the possiblity of infection through mucosal contact with saliva, as levels of HBV can vary in saliva depending on stage of infection and the host's immune response (see HBV persists in saliva). Transmission through saliva through kissing has not been documented by the CDC, but transmission through contact with saliva through bites has been.

The CDC suggests the following people are at risk for HBV infection:

-Persons with multiple sex partners or diagnosis of a sexually transmitted disease

-Men who have sex with men

-Sex contacts of infected persons

-Injection drug users

-Household contacts of chronically infected persons

The CDC does not identify casual contact as a risk for HBV infection. If you are sexually active, you should consider getting immunized against HBV infection.

HIV is only transmitted through contact with a woman's breast when an uninfected infant breast-feeds from an HIV infected woman. There is no evidence that people get infected through contact with a woman's breast/nipple during sexual contact.

RMK



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