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Confused by HIV / HBV risks !
Feb 20, 2008

Hello Dr. Bob,

I Hope you're fine. To start with I just want to say that you do a very, very good and important job here on the net by giving clear answers and hope to worried people. Don't get annoyed by churchladies or other religious maniacs, doing good things remains doing good things, no matter if ur black, white, gay or not, italian or americangod bless you, or I prefer to say may Buddha enlighten you ...

Well I am not that well enlightened for sure and I got into real poor judgement 6 weeks ago which is leading to my story / questions. First of I am from the E.U. and I hope my english is good enough, lots of people here visit your side since most sides in the European Union can not keep pace with this one. I had unprotected mutual oralsex (no intercourse) with one special lady (sex worker). I know now this was extreme stupid. I guss it's the same thing world-wide: men act stupid if sex is ahead and also they act penis-driven. However turning back the time is not possible for us. So because of massive worrying I went to see my doctor to whom I confessed all. He calmed me down to be realistic and not to overreact, he also gave me on the seventh day after the oralthing following medical treatment, to calm me down: PEP for HBV(hepatitis B) on day 7 - Immunoglobin B & HBV-vaccination, PEP for Syphilis & Bacterial STIs: one big infusion of Rocephine and one week of daily levofloxacin, NO(!) HIV PEP as it's not recommanded here in Germany if you had ,,only" oralsex (my Doc said). After that medicine (damn! cost me incredible 1200 ) he said, 99% of any living bacteria in my body would be dead, also chances would be good to prevent possible HBV infection. HIV risk would be low anyway. OK, after 3 weeks he tested me HIV antibody and P24 negative, TPHA (Syphilis) negative, HBV-PCR negative. All tests to be repeated after week 6. Sorry Dr. Bob that I bother you with questions not really related to HIV (I think my HIV risk is real but very low) but that HBV-thing and Syphilisthing is driving me insane and the fear won't subside. Now here are my questions, because I am confused about that PEP stuff and testing again ...

1. Most people are afraid of HIV but isn't HBV 100 time more invectious and Syphilis as well? Why do people not worry that much about HBV? And can you get HBV by mutual oralsex? I know that it is very very easy to get Syphilis this way...

I will repeat HIV test and TPHA, but my doc said HBV tests could not be repeated because of risk of falsifying results by the Immunoglobin and Vaccination.

2. So what should I do about that HBV risk? Was the HBV PEP enough or should I do another expensive HBV-PCR to be sure?

3. Basically: what is more serious for our health: HIV or HBV???

I would be very happy to hear something from you. And maybe this answer is interesting for other worried people too!

Thanks a lot,

The not-enlightened Guy

Response from Dr. Frascino

Hi Not-Enlightened Guy,

Thanks for your kind comments!

I agree HIV PEP would not be warranted for oral sex. The treatment your physician provided would be considered aggressive by most standards. Generally speaking hepatitis B immunoglobulin would not be recommended for disease prophylaxis related to oral sex! Likewise Rocephin and levofloxacin were probably overkill as well, in my opinion.

To address your specific questions:

1. Hepatitis B (HBV) is transmitted sexually primarily through unprotected anal sex. Transmission orally would be difficult. Once vaccinated you should be immune.

2. Your HBV risk is negligible. I see no cause for concern or reason to do an HBV PCR! (You've spent way too much money on this blowjob already!)

3. HIV is the more serious health risk for a whole variety of reasons, not the least of which is that HIV is a chronic progressive terminal illness; most cases of hepatitis B are not.

Dr. Bob



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