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What are the chances of hepatitis C and B transmission through breast secretions?

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Posted on Mon, 18 May 2015
Question: Hi Doctor ,

6 weeks before i went to CSW and sucked her breast, and i remember i swallowed something. and then she masturbated me by hand. Will this cause HEP C and HEP B?

Also could you please provide me the right window period to test HEP C and HEP B?

Please help me , i am worrying a lot
doctor
Answered by Dr. Prasanna Heijebu (1 hour later)
Brief Answer:
Get tested at the earliest.

Detailed Answer:
Hi Sir.

I understand your concern.

Yes there is a moderately significant possibility of transfer of infection ob both hep b and c through breast secretions.

The window period for Hep C is 6-8 weeks.

There is no defined window period for Hep B.

The test will be positive several weeks before the onset of clinical symptoms.

Hence I advise you to get tested for both immediately now.

Post your further queries if any.
Thank you.




Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Prasanna Heijebu (22 minutes later)
But i heard window period for hep c is 6 months and hep b is 6 weeks? also when i checked the transmission blood to blood to contact for HEP C and blood and genital fluids for HEP B? but your are giving the different view. am i in the high risk exposure?
doctor
Answered by Dr. Prasanna Heijebu (14 hours later)
Brief Answer:
Risk of transmission for breast secretions is even low still exists.

Detailed Answer:
Hi Sir.

I have given you the window periods based on most recent guidelines on viral hepatitis.

I do not say you are at high risk.

I mean that you are at "significant risk" since viruses have been isolated from breast secretions under controlled lab conditions.

Of course the risk of transmissions is still less than blood to blood and blood to genital fluid transfer.

Also risk is more with practises like association with CSW.

Hence to be on a safer note I recommend strict measures.
Thank you.




Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Prasanna Heijebu (2 hours later)
Thanks , i have given blood for DNA PCR for hep B - HBV DNA detection and RNA by cobas for HEP C HVC RNA Detection by COBAS Taqman by today, expecting my results by Tuesday , will that be conclusive? or do i need to do any more test after 6 months?
doctor
Answered by Dr. Prasanna Heijebu (1 hour later)
Brief Answer:
These tests are 100% conclusive to diagnose infection.

Detailed Answer:
Hi .

Yes these tests would be absolutely conclusive to detect both Hep B and Hep C virus since viral nucleic acid-dna/rna testing is ultimate.

You do not need further tests after 6 months as far as diagnostic part is concerned.

Post your test results for further accurate interpretation.

Thank you.


Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Prasanna Heijebu (3 hours later)
Thanks for the confirmation, i am not clear about the below statement

"You do not need further tests after 6 months as far as diagnostic part is concerned."

Diagnostic part?? I have done blood RNA/DNA test. will this be a good test?

Also why HEB B doesn't have RNA test? all labs are offering only DNA test?

Am i selected any wrong test here? Help me out.
doctor
Answered by Dr. Prasanna Heijebu (28 hours later)
Brief Answer:
Hep b is always tested for dna only.

Detailed Answer:
Hi

I mean you have chosen the right kind of tests for making your diagnosis,is to know if you are infected with hep b or c or both.

Hep b is tested for the presence of DNA only,since this virus is biologically made of DNA only but not RNA.

Hence you have ordered the right test and not misguided by any lab services.

All labs thus offer only hep b DNA tes t only.
Thank you
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prasanna Heijebu (41 hours later)
Hi Doctor ,

I just received my HEP B DNA detection report , i have attached the same for your reference.

I too have below doubts

1) Is the test is conclusive or do i need to do any more test in future?
2) Why in Result Interpretation the lab mentioned with below details
"A NOT DETECTABLE result indicates the absence of HBV infection or
resolved/convalescent stage of infection or the viral copies is below 20 IU/ml."

Is there a chance for HEB B virus missed in my sample? or my test is good.

3) I believe i too have HIV risk for the above activity. I have tested with 4th generation test at my 29th day and it came back with Non - Reactive. I did same RNA pcr test for HIV 1 & HIV 2 on my 35 th day , both came with NOT DETECTABLE. DO i need to do any more test for HIV?

Please suggest me.
doctor
Answered by Dr. Prasanna Heijebu (14 hours later)
Brief Answer:
Need not test again for Hep B and HIV.

Detailed Answer:
Hi .

I understand your concern.

You need not take another test for Hep B.

You seem not to harbor this virus.

Hence termed Non Detectable.

Regarding interpretation,the test sensitivity limit is 20 IU/ml .Its the minimum quantity/viral load that has to be present for viral detection.

This does not imply that you have levels below this value.

Its a test limitation.

You need worry about this.Just ignore.

Your test is absolutely good and safe as of now.

Likewise you do not need another HIV test,since 4th gen tests are extremely accurate and sensitive on day 29 and day 35 as well.

Thank you.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Prasanna Heijebu (1 hour later)
Thanks, I have attached HEP C report for your reference. Kindly have a look and let me know your suggestion and also please clarify my below doubts

1) Alcohol consumption before test (6 hours) will impact the results?
2) All my results are conclusive , is there a chance for me to get positive later for this exposure? The only mistake i did this the above mentioned exposure apart from that i dont have anything.
3) Do i need any more test later ?

Shall i move on with my life?

Thanks.
doctor
Answered by Dr. Prasanna Heijebu (10 hours later)
Brief Answer:
You can move on,all tests are conclusive enough.

Detailed Answer:
Hi Sir.

I understand your concern.

I have gone through your uploaded reports.

Alcohol consumption will not alter your test pertaining to HCV rna detection.

Yes all your reports are conclusive.The chance to revert to positivity is extremely low pertaining to Hep B and Hep C.

Pertaining to HIV,the current result is validated and conclusive.
But for your personal satisfaction,you can even go further 1 step ahead for Western blot testing for HIV .This test is 100% specific and sensitive.But its only optional in your case.If you want to use the available medical technology to fullest,go ahead.

As of now you can move ahead with life.

I advice you to have absolutely safe sexual encounters from next time to avoid experiencing undue fear and anxiety .

Take care.
My best wishes.

Thank you.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Prasanna Heijebu (28 minutes later)
Thanks Doctor. I will never ever do any mistake , i have my own partner i will be live with her happily.

My last and final doubts i believe

1) I believe alcohol consumption will not affect any of my test ( HEP B , HEP C or HIV)
2) Do i really need to go for Western Blot ? Or all my tests are good and i can loudly say i don't have HIV
3) As you said "The chance to revert to positive is extremely low pertaining to Hep B and Hep C." , So still is there any chance? because , i am married , hopefully you understand my situation.


Just consider all my reports and doubts and provide me some conclusive statement to proceed further with my life.

Thanks for all your help.
doctor
Answered by Dr. Prasanna Heijebu (22 hours later)
Brief Answer:
Overall you are virtually out of the risk for these viral disorders.

Detailed Answer:
Hi Sir.

I understand your concern.

Yes alcohol consumption will not affect the viral nucleic acid estimation.

Western blot is only an option.Not a mandate in your case.Yes you can loudly say that you don not have HIV based on the test results.

The chance to revert is extremely low for hep b /c is low in view that a negative test either implies viral copies less than 15/20 IU PER ML or absolutely zero copies as you already know. Hence I mentioned it as "extremely low".But its just a casual way.You need not take it to worry.

Risk of recurrence shows on clinical signs and symptoms and only then retesting is needed.

But as of now the risk of hep b/c is insignificant.Need not worry about it.

Please concentrate on your life projects ahead and forget past.
Stay happy and lead a wonderful marital life with your wife and children.

Hence you can be conclusive of your current situation.

Thank you.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Prasanna Heijebu (3 hours later)
I checked with my pathologist ans she said i don't need to take any more test, if there is no virus in blood why i need to get symptoms later? i asked about viral copies , my pathologist ,she said that only for person who is in therapy.

Because without conclusive result , how can i move on with my wife? if something happened to her my kid , i don't know how to proceed further.

When can i get my conclusive report? when can i loudly say i don't have HEP B or HEP C?
doctor
Answered by Dr. Prasanna Heijebu (11 hours later)
Brief Answer:
You are in very safe zone.Be not obscessed.

Detailed Answer:
Hi Sir.

You seem to be obsessed with your current situation.

You are safe.

You do not need further tests.

I totally agree with your pathologist.

You have taken the most conclusive tests available in the world pertaining to Hep B and C.

There is no tests beyond those what you have taken for diagnosis so far.

Testing for Viral nucleic acid like DNA and RNA is ultimate.

When there is no virus,there will be no symptoms.

I mentioned this-"Risk of recurrence shows on clinical signs and symptoms and only then retesting is needed"...as a fact of academic interest(it happens only in <2% individuals for unknown reasons.....science of medicine is vast with many uncertainties) for all those whose titers fall below 15/20 IU per ml and keep you on toes for early detection(as a second line safe measure),since you have no tests which can detect such low levels of virus.Even then once symptoms develop with such low levels of virus,excellent treatment options are available which can offer you cure against Hep B and C.This is quite unlike in HIV where cure is not possible even with medications when viral levels are detected at lowest levels.

Hence you can be rest assured with your results.

Post your further queries if any.
Thank you.




Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prasanna Heijebu (2 hours later)
Thanks doctor, yes i am worried daily , and looking something in body all the times. One last thing about HIV doctor, I heard streriods can make the window period delay , since i have take some steroids after my exposure

Below are my tablet details which i have taken

(09/03/2015)
betnesol forte 1mg for 3 days
T Nupan 40 for 3 days
T hhlevo 5mg for 15 days
I ivercid 12mg for 1 days

12/03/2015
ivercid 12 mg for 1 dayt.
Lorspan for 10 days
T hhlevo 5mg for 15 days

betnesol forte 1mg is a oral steroid tablet , will that affect the results?

I used to get fever , I ll take antibiotics and injection (i don't know what they will inject) , Before my exposure i believe 2 weeks before i had a fever took antibiotics and injection , after my exposure i took those above mentioned tablets , i believe betnesol forte 1mg is the only steroid tablet in my list or is there any other in the list? then after 2 weeks of my exposure i got throat infection , i went to doctor again injection , antibiotic and "NO COLD" tablet taken for 6 days. Thats all , i believe these will not affect my test results?

Thanks in Advance.
doctor
Answered by Dr. Prasanna Heijebu (19 hours later)
Brief Answer:
All factors you mentioned DO NOT affect your overall test result.

Detailed Answer:
Hi Sir.

I understand your concern.

Yes betnesol forte is the only steroid in the list.

Steroids do not delay window period in HIV infection.

And intake of 1 mg is a very low dose almost negligible.

Overall these drugs do not affect your testing.

4th gen DUO testing are highly specific.
They are least affected by steroid intake.
You can be rest assured on this.

Post your further queries if any.
Thank you.


Above answer was peer-reviewed by : Dr. Prasad
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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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What are the chances of hepatitis C and B transmission through breast secretions?

Brief Answer: Get tested at the earliest. Detailed Answer: Hi Sir. I understand your concern. Yes there is a moderately significant possibility of transfer of infection ob both hep b and c through breast secretions. The window period for Hep C is 6-8 weeks. There is no defined window period for Hep B. The test will be positive several weeks before the onset of clinical symptoms. Hence I advise you to get tested for both immediately now. Post your further queries if any. Thank you.