Hepatitis C risk

[Anxiousmale39]

Hi had a sexual encounter with another man in May of last year which I am getting very anxious about. I received protected anal sex and performed unprotected oral sex on him.

I have been for a full STI screen for Chlamydia, Gonorrhoea, Syphillis, Hepatitis B and HIV which have all come back negative.

However, I am now obsessing and worrying that I may have contracted Hepatitis C.

My reasons for this are that I performed deepthroat and gagged a little which may have damaged my throat and created a pathway for Hepatitis C transmission.

I also sniffed some poppers from a tissue (not directly from the pot) and am worried that could have also been a risk. I did not see any blood during sex but am scared about this encounter.

I have been having pains in my abdomen (right side) and burning pains in my legs, back and feet. I am now very concerned about Hepatitis C.

I am unsure if my symptoms are due to my anxiety and stress I am putting myself under but I am constantly checking my body for signs of Hepatitis C (fingernail changes, jaundice in eyes and face etc).

Can anybody help?

[Lynn K]

From the US CDC FAQ hepatitis C for the general public

https://www.cdc.gov/hepatitis/hcv/cfaq.htm#C1

“Transmission / Exposure
How is hepatitis C spread?
Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to prepare or inject drugs. Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. After that, widespread screening of the blood supply in the United States virtually eliminated this source of infection.

People can become infected with the hepatitis C virus during such activities as:

Sharing needles, syringes, or other equipment to prepare or inject drugs
Needlestick injuries in health care settings
Being born to a mother who has hepatitis C
Less commonly, a person can also get hepatitis C virus through

Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
Having sexual contact with a person infected with the hepatitis C virus
Getting a tattoo or body piercing in an unregulated setting
Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.”

Hepatitis C is a blood borne virus meaning blood infected with hepatitis c must enter the blood stream of an uninfected person. There have not been any transmissions in the manner you have described.

Greatest risk of transmission is for those who share IV drug needles, had a blood transfusion before 1990 when antibody testing was developed and the blood supply secured, having multiple sexual partners or participating in rough sex like BDSM or blood sports or unprotected anal sex where there is a risk of infected blood entering the blood stream of an infected person.

Even in the case of a health care worker who should experience an accidental needle stick involving a patient with known hep c the odds of transmission are only about 1.8%

Less than 4% of the US population has hep c so your odds of randomly encountering someone with hep c are relatively low.

https://www.hepcassoc.org/news/article27.html

“ There are no known cases of HCV being transmitted through oral sex on a man (fellatio) or a woman (cunnilingus). However, it is theoretically possible that the virus could be transmitted this way if a person has mouth sores, bleeding gums, or a throat infection.”

The vast majority (80%) of people newly infected with hep c experience no symptoms. The most common symptom is tiredness. This is why hep c is called a “silent illness”

Again from the US CDC

“Symptoms

What are the symptoms of acute hepatitis C?
People with new (acute) hepatitis C virus infection usually do not have symptoms or have mild symptoms. When symptoms do occur, they can include:

Fever
Fatigue
Dark urine
Clay-colored bowel movements
Abdominal pain
Loss of appetite
Nausea
Vomiting
Joint pain
Jaundice (yellow color in the skin or eyes)”

When people do experience symptoms most often is after decades of infection and then the symptoms are those of advanced liver disease. Only about 20% of those infected for 20 years will develop advanced liver disease and cirrhosis.

While LRQ pain can be associated with liver injury this would likely be reflected in a liver enzyme panel. The burning pain in your legs and back is not associated with hepatitis c. The other symptoms you mention like nail changes and jaundice are symptoms of advanced liver disease not initial infection. Having jaundice would also be identified by elevated bilirubin levels.

From what you have described I very much doubt you were at any risk. However, as you said this incident was last May you have waited well past the minimum recommended time of 12 weeks and the maximum time of 6 months before you can confidently expect very reliable antibody testing results so if you have concerns simply have a hep c antibody test performed then you will know your hep c status. 

Also, even if you should learn either now or sometime later in your life you did somehow contract hep c know that today hep c is very treatable. The meds that have been approved since 2014 are very effective at curing hep c boasting cure rates at 98% and higher. Treatment can be as simple as one pill a day for as few as 8 to 12 weeks and you would be cured. Hep c takes many years to decades if ever to cause liver damage.

So basically your worried about an illness that today is very curable that has few symptoms and takes a long time to cause serious damage in most cases.

I’m assuming as you mentioned anxiety a couple of times you probably are aware you have anxiety issues. I would think you should discuss your concerns about contracting a difficult to contract illness that is very curable with your counselor. Like I mentioned you can get a hep c antibody test for peace of mind but somehow I doubt having testing done will truly ease your mind. For help you might consider anxiety counseling and possibly anti-anxiety medications to enhance your quality of life. 

Best of luck

[Anxiousmale39]

Thank you Lynne. The information is very helpful.