In a panic, help greatly appreciated.

[LaneMyer]

I've gone through weeks of severe anxiety about HIV and HSV but with help from internet forums realized my contact really wasn't a vector, below lottery chances low.  I am now petrified of Hep and search results from HIV keep getting in the way of HEP information.. When I read HEP lives a long time outside of the body and all the precautions required to clean up spilled blood I started freaking out.  I know I'm going to have psychosomatic "symptoms" and will avoid asking about those.

I tried to be safe, there was no penetrative or oral sex.  I picked up a sex worker four weeks ago for a hand job.  Chances are she is an IV drug user.  I had her use Purell first.  She was using left hand.  Things were taking a while so I put some lotion on her left hand.  I then asked her to finger herself with her right hand as an additional turn on.  Then, she decided to switch hands! Before I could stop her the right hand was on my penis.  I'd say she got in a stroke or two as I screamed no; but there wasn't more than a second or two after her hand left her underwear and then was on my penis.  There certainly would have been trace amounts of vaginal fluid present, possibly blood depending if she had any rough sex with other customers.  The fluid likley would not have entered into my urethra but would have been on the shaft and meatus. I'm sure I had developed some "microtears" from the dry rubbing prior to the cream. That could be a pathway to the bloodstream, read about this in HIV information.  I tried to be careful but there was this unpredictable factor.   I instantly nuked my penis with Purell wiped and applied again.

*Experts assure the HIV virus is not spread because it has died in gental to hand to genital contact - this wouldn't be true with Hep though, correct?
*Would any of the remaining hand cream left there provide any form of barrier?
*Would the Purell nuke have any chance of killing the virus before it would infect me?
*From what I have read Hep C infection this transfer seems much less likley, most of my concern is about B, but as I said she was probably an IV drug user so would blood to blood transfer fom vagina be a feasible possibity per "microtears" since Hep 100 times more infections than HIV?
*I'd guess she was in her early 20s, so it is possible she would have had immunizations as an infant, but would that have "worn off"?
*Overall,kl if she was accute/cronic B or C how bad of a transfer vector would this contact be?

I have a SIGNIFICANT anxiety disorder and always catastrophize .  Hypocondrisis is in full swing here.  I'm drinking like a fish and mixing in benzos right now; very bad.  Some information here could really help with my catastrophization and mental health.  I do see a psychiatrist already. 

When can I accurately test for B/C?  I wish I would have known about the ability to treat B after a possible exposure.  I'm going to get vaccinated if it turns out I didn't catch it.

I want to thank everyone who has taken the time to read this.  Again, replies greatly appreciated, even if it is bad news.
- Lane -

[Lynn K]

As you said "below lottery chances low."

Hep c requires blood to blood contact for transmission. Even a health care worker who experiences and accidental needle stick involving a patient with known hep c the odds of transmission is around 1.8%

You can test at 3 months for hep c but for most accuracy 6 months is best.

Even if you did from this exposure or at any other time in your life ever become infected with hep c with the new medicines hep c is now very curable for most people so even if you ever have hep c simply get treated and cured so either way nothing to worry about regarding hep c.

I cannot speak to hep b as I am just a patient myself who was infected with hep c until I was cured last year

But my suggestion is you discuss all this with your counselor. It seems that your anxiety is you single greatest health problem not the exceedingly small chance of contracting a now curable illness hep c.

Also as it seems you are concerned about contracting illnesses why would you have relations with sex workers? Especially why would you not use without protection? When having sex you should always use barrier protection i.e. condoms this would prevent the exchange of any bodily fluids thus reducing the chances you would catch any STD.

See your psychiatrist and discuss your concerns with them.
Best of luck

[LaneMyer]

Thank you for the reply Lynn. 

I'm bipolar, my anxiety manifests itself strongest during hypomanic states, as does "hyper sexuality".  I know picking up sex workers is a bad thing, it's only happened when I go abruptly from a mixed state into hypomania that this has happened.  Crazy isn't curable, but it isn't contagious and is usually a manageable disease.  I'm on 3 meds now, this experience signals time to increase dose, add another, or  change to another.  I've been fortunate in not needing to take meds that cause awful side effects, such as a tick or make me lactate.  Ill get to worry about “Stevens-Johnson Syndrome” again if I increase my Lamictal dose.  I'm sure you had your fair share of side effects while curing your Hep C.. Congrats!  I do have Ativan for dealing with this stress in the short run 6 months of waiting but that is not something to use long term.

I didn't think a condom was necessary for a handjob to be safe sex.  I hadn't imagined her switching hands; I now know otherwise.  I haven't had intercourse in many years so condoms aren't something I keep around, and they would expire.  Maybe the step of going to buy a condom beforehand will provide an additional interrupt/sanity check to rethinking my actions if this starts to happen again.

The 1.8% from a direct needle stick -- that is a very comforting statistic, thank you so much!  It is particularly relevant to me right now.  My son had walnut stains on his hands and decided to use nail clippers to try to remove them yesterday.  Needless to say he cut himself badly in a few places.  I have dozens of nail clippers in the house and I am just thinking, what if he had used the set I last had?  What if I had cut myself with them slightly and didn't know it?  I had clipped my fingernails closely a week beforehand after a camping trip since the nails were dirty.  I scolded him more than appropriate and then had to go away in  tears for a while.  He apologized to me later, that just wasn't right.  Afterwards I found every nail clipper, file, etc and cleaned them with bleach.  I hid a set for myself.  I bleached my toothbrush.  I took a new toothbrush, my razors and electric shaver into work.  I'll be brushing and shaving there for a while.

Does anyone have information on Hep B for my original questions?  I think you can test much sooner, right?  With Hep B known to be much better transmitted sexually than C where do things stand for my exposure?  I know I asked a ton of questions but details and then odds calculations will provide me some comfort. That 1/10 becomes chronic and incurable is very scary.  My children's Mother was good about vaccination so I'm reasonably certain they would have received the vaccine for B and should be good, right?

Again, thank you very much to all who can reply. 

[LaneMyer]

Here's a drastically less verbose description for my question. 

I was getting a dry handjob from a sex worker,
she used Purell beforehand. 
After a while hand cream was applied for lubrication and continued. 
She was rubbing her vagina with her other hand and placed it onto my penis for a very brief period.

What are B and C risks for that brief contact, assuming she had vaginal fluid and possibly trace amounts of blood on her hand?  I believe B risks higher.

contributing factors
creme was on my penis, would that be providing any barrier
I instantly applied hand santizer to my penis after the contact, would that help at all?

Please weigh in on my risks..  THANK YOU so much.

[Lynn K]

I do have this for you from the CDC about hep b

http://www.cdc.gov/hepatitis/hbv/bfaq.htm

How is Hepatitis B spread?
Hepatitis B is spread when blood, semen, or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus during activities such as:
Birth (spread from an infected mother to her baby during birth)
Sex with an infected partner
Sharing needles, syringes, or other drug-injection equipment
Sharing items such as razors or toothbrushes with an infected person
Direct contact with the blood or open sores of an infected person
Exposure to blood from needlesticks or other sharp instruments


Can Hepatitis B be spread through sex?
Yes. Among adults in the United States, Hepatitis B is most commonly spread through sexual contact and accounts for nearly two-thirds of acute Hepatitis B cases. In fact, Hepatitis B is 50–100 times more infectious than HIV and can be passed through the exchange of body fluids, such as semen, vaginal fluids, and blood.

What are ways Hepatitis B is not spread?
Hepatitis B virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing.

While a condom might not be necessary for a simple manual manipulation sometimes things can progress from there so having a comdom on already would be a plus. Also I think it would certainly help you to have fewer concerns now had you worn one.

My prior treatments with interferon were tough at times yes but my final successful treatment with Harvoni was basically really easy like taking a daily vitamin.

Really though even people who have chronic hep b live normal lives it is for me really hard to imagine being afraid of catching an illness. I worry about liver cancer because of my cirrhosis but not all the time. I just live a normal life going to work etc.

I understand it is not anywhere near that easy for you and I do wish you ge best. But really I don't believe personally as a non medical person that you should have any concerns from this exposure to either hep b or hep c

Wishing you the best

[LaneMyer]

I have my 6 week tests on Tuesday.  According to commercial testing pages and thestdproject this puts me in the recommended and "likely detection" window.  December 5th will be 12 weeks, which is categorized as "highest accuracy". 

I really wish there was better information on Hep and Herp risks vs HIV.  I know the former aren't nearly so life threatening.  I also know that I have no risk for HIV through a wealth of information on may websites..  I've read conflicting information on HSV and Hep risks though.

The testing windows are pretty well defined, though even there exists some conflicts.  I'm posting this for other people who want to know how soon they can breathe the sigh of relief.

From the commerical site,
"Although it is possible to detect hepatitis B as early as 3 weeks after infection, our doctors recommend waiting at least 6 weeks to test for accurate results."
"Different people react differently to the Hepatitis C Virus (HCV). On average, it takes the body about 8-9 weeks to create antibodies. This is the time recommended by our doctors to test for hepatitis C. You should also have a follow-up test 3 months post-exposure to confirm that there is no active hepatitis C (HCV) infection."

From the STDsite.com
Hepatitis B Blood Test:
    Possible Detection – 1-6 Weeks
    Most Likely Detection – 6-10 Weeks
    Highest Accuracy – 12 Weeks
Hepatitis C Blood Test:
    Possible Detection –  4-5 Weeks
    Most Likely Detection – 6-9 Weeks
    Highest Accuracy – 10-12 Weeks

There is a definite discrepancy for Hep C tests between the 2; I'm wondering if there was a typo..

My PDoc (psychiatrist) started me on Zyprexa for my crazies.  I've done SSRIs, SNRIs, and Anti Epileptics over the past 25 years.  This is my first entry into the AP category.  I really am having a hard time with that P.   Side effect profiles are worse, though the second gen are reportedly reduced/less common.  I might get fat or diabetes but it might save my life or quality of as well.  Here's hoping I don't get so stupid manic again.

As before, thanks to all who are reading this and who respond.

[LaneMyer]

 6Wk - YAY

Hepatitis B Surface Ag confirm    Nonreactive 
Hepatitis B Surface Ag confirm    Nonreactive      Nonreactive

Much less concerned now.  In 6 more weeks I can put this to bed totally!