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How soon should I test for Hep B?/ Window Period for Hepatitis?
Mar 25, 1997

Question #1: How soon should I test for Hep B?

Recently the condom broke when I was performing insertive anal intercourse. I will get an HIV antibody test in 6 months, but how soon should I be tested for Hepatitis exposure (either A or B)? This incident scared me--if my Hepatitis test is negative, I'll get the vaccine (I'm a gay man). But I want to make sure any negative result is REALLY negative before getting vaccinated.

Question #2: Window Period for Hepatitis? How soon after contact will an infected person test positive for sexually transmitted Hepatitis?

Response from Mr. Sowadsky

Hi. Thank you for your questions.

Hepatitis A and B are transmitted in different ways, although both viruses can cause Hepatitis (inflammation of the liver).

Hepatitis A is transmitted through the oral-fecal route. It is usually transmitted through food. However sexually, it could be transmitted by giving oral-anal sex (rimming) to an infected person. It is not transmitted by intercourse. So even if the condom broke, you would not be at risk for Hepatitis A. In terms of when a person starts showing symptoms of Hepatitis A after they're infected, the incubation period is 15-50 days, with an average of 28-30 days. A person would start showing positive on a Hepatitis A antibody test during the acute illness, and for about 4-6 months afterwards.

Hepatitis B is transmitted the same way as HIV, however Hepatitis B is 100 times more infectious than HIV. If a condom breaks during intercourse, infection with Hepatitis B would be a possibility, even more so than HIV (assuming the partner is infected with either virus). The incubation period (when a person starts showing symptoms) for Hepatitis B is usually 45-180 days with an average of 60-90 days.

There are several tests that we can use to detect Hepatitis B. These include both antigen tests and antibody tests. The Hepatitis B Surface Antigen (HBsAg) test will start showing positive several weeks before onset of symptoms and can stay positive for days, weeks, or months after onset of symptoms. In persons with chronic infection, this test may continue to show positive for many years (even for life). Presence of the Hepatitis B surface antigen indicates the person is actively infectious to others. As far as antibody tests are concerned, a person tested for certain types of antibodies will remain positive indefinitely. However, a specific type of antibody (called IgM) occurs primarily during the acute infection and disappears in 6 months after infection. There are other types of antigen/antibody tests in addition to these.

By testing for various antigens and antibodies (to Hepatitis B), we can determine if a person is actively infectious to others, if they were recently infected, or if they were infected years ago. Tests can also determine if a person is immune to Hepatitis B. Very often, both antigen and antibody tests will be run simultaneously on a "Hepatitis Panel".

Besides the tests listed above, liver function tests can also help diagnose viral Hepatitis. It's important to remember that not all people with Hepatitis A or B will develop symptoms. If you have never been infected with either Hepatitis A or B, there are now vaccines available against both of these viruses. There is one vaccine for Hepatitis A, and another for Hepatitis B. Both are highly effective at preventing these forms of Hepatitis, in persons who have never had these infections previously. However, neither the Hepatitis A or B vaccines will work against Hepatitis C, nor other forms of viral Hepatitis.

Hepatitis C can occasionally be transmitted sexually as well, although it's most often transmitted through direct blood-to-blood contact. The incubation period for Hepatitis C is 2 weeks to 6 months, but most commonly 6-9 weeks. There are tests for Hepatitis C, but they often can't distinguish between recent and previous infection. Improvements to Hepatitis C testing is currently underway.

I strongly encourage anyone whose at risk for either Hepatitis A and/or B, to be vaccinated against these viruses. All of the Hepatitis viruses are highly preventable. These viruses can lead to severe and potentially life-threatening health problems. This is especially the case with Hepatitis B and C, which can be fatal, and can be linked to liver cancer.



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