Constant fear of transmitting the virus

General Discussion
65

Thanks Thomas this really helped me I made my family panicked over always cleaning every single spot I step on after returning from hospital

66

If this is something your family worries about (hepatitis is only one of many diseases out there), it would be good to consider removing your shoes before you’re inside the house.

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67

Thank you so much sir.I was thinking that since tdf stops new cell from being infected,if an individual is already on tdf for hep b, assuming such one contracted HIV along the way,I was thinking they won’t be much antibody/antigen in the individual system to detect in HIV test

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68

That’s to say long term it will affect HIV test? @ThomasTu

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Please sir,in this scenario the hep b positive female adult don’t know her viral load and not on medication.is the chance of transmission still negligible?

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71

No, as mentioned above it should not affect HIV tests.

As mentioned above, if the man and woman do not both have any breaks in their skin, the risk of transmission from this act is negligible.

Thomas

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72

Hello,

I am HBV positive and E antigen negative with a DNA of 100 IU/ml. I had a baby 3 months ago and he was vaccinated with a first dose. He not received the second dose yet but will next month. I work in construction and always have scratches and cuts on my hands and baby always scratches his face.

  1. How long does the first dose of vaccine last?
  2. Is there any danger of transmission to baby if our scratches and cuts touched or I had scab that was bleeding and baby touched with his scratch? I’m really worried
  3. Is it ok to have the second dose 4 months after 1st or does it have to restart?

Thank you,
Roberto

73

Hi @RobertoS,

First, I wanted to welcome you to the community. I am glad you found us and I hope we will be a good support for you.

I just wanted to inform you that there may be a delay in response from an expert. So please be patient as many of our experts are very busy currently.

I wish the best for you and your baby and your family. Again, welcome to the community and thank you for your patience.

-Paul

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Hi Paul,

Thank you for kind words. Hope the experts will reply.

Roberto

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75

Dear @RobertoS,

Thanks for these important questions.

Re: vaccination, the idea is that it takes several doses of the vaccine to induce lasting protection. Each dose will stimulate production of antibody that protects in the short term, but children get multiple doses so that they will maintain it. The dosing is such that the boost happens before the antibody goes down below protective levels. You can see in this article that children’s antibody levels remain quite high during the dosing period: https://jag.journalagent.com/hnhjournal/pdfs/HNHJ-69335-RESEARCH_ARTICLE-ATAY.pdf

The above article also shows that if the mother is vaccinated, their antibodies are passed through to the baby and helps protect them in the first few months after being born.

Regarding the transmission from scratches, I think this is difficult to specifically answer given noone has done the experiments in these contexts. However, there is data on how often transmission occurs during birth (which is an event where there is a lot of bodily fluid transfer between mother and child). When appropriate vaccination schedules are followed, no transmission is seen when the mother’s viral load is less than 100000 IU/mL (https://hal.science/hal-03493664/file/S1473309920305934.pdf, figure 2A), which is 100-fold higher than your viral load.

Another point is that breast milk can contain up to 1000 IU/mL of HBV DNA (https://journals.sagepub.com/doi/pdf/10.1177/08903344211043066?casa_token=Nz0UxGWSFNUAAAAA:_-Ml4AwiDM5uB12KRg5R5Hk9CZU6KpiVNENcVi6rfMOqpM0-OogH08zy5UBZQqh3yeoW6YXcZKJ0NHo), but breast feeding has not been linked with any additional risk of HBV transmission as long as children are vaccinated appropriately (Breastfeeding Is Not a Risk Factor for Mother-to-Child Transmission of Hepatitis B Virus).

I am not a medical doctor and this should not be taken as medical advice (and I’m happy to be corrected by any @HealthExperts here). These are different settings that the one you are facing, but these studies might provide you with some indication of transmission risk.

If you are worried about it, it might be useful to talk to your doctor about it and ask for an antibody level test for your child to see if they are at protective levels.

Hope this helps,

Thomas

78

Thank you Thomas for your reply and for all that you help for community!

I have some follow questions:

  1. Why is vaccine immunity higher at 3 months with only one dose than at 1 month? Should be highest closest to the injection, no?

  2. Why some hospitals say give second dose at 2 months instead of 1 if at 1 month 20% still below 10mlU/ml? Should not be mandate at 1 month?

  3. Is the 10mlU/ml setting just a high limit protection against a very high load and could lower mlU/ml setting still protect against very low load?

Sorry if too many questions.

Thank you again,

Roberto

79

Dear Roberto,

Thanks for the questions:

The immune system can take time to build up antibodies.

I’m actually not sure, but it likely has something to do with being the optimal amount of time between vaccines to make sure that the most amount of antibodies persist for the longest amount of time afterwards. If you just keep giving the vaccines one after another, they don’t work as well as if you give the immune system a little bit of a pause between each vaccine. @nina.le.bert is an HBV immunologist who might be able to provide more answers on this.

I’m not sure that is really known. My understanding is that the 10mIU/mL limit is more of a rule of thumb rather than something that is backed by well-controlled studies.

Thomas

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80

Dear Roberto,

I don’t have much to add to Thomas’ replies.
Antibodies often take time to develop, maturity maturation continues even for up to 6 months. So it is possible that the antibody titer is higher at 3 months than at 1 month post first dose.

For HBV vaccines, the recommended interval between dose #1 and dose #2 for infants is 1-2 months. Some argue it is better to prolong time between vaccinations, but any time between 1-2 months should not make any difference. The dose #3 is given at 6-18 months.
What is more important (in case the second dose was delayed), is that the interval between dose #2 and dose #3 should be at least 8 weeks.

And yes, the 10mIU/ml is more a rule of thumb which has shown to be protective. This does not mean that a lower antibody titer does not protect, it has just not been tested in well-controlled studies.

Nina

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81

Good day sir.How are you going with your research. Can mosquito bites or houseflies perching on open wounds transmit hbv since it’s a Hardy virus

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I am not aware of any research showing that this is an efficient way to transmit the virus.

TT

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This studies I found got me scared always @ThomasTu @john.tavis @ScienceExperts

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All salute professor, scientist, virologist Thomas Tu, you deserve all accolades.You are such a learned man.You should consider teaching one day :grinning:,you have a way of explaining things, infact you are such an amazing person and I admire you,with the little of you I have know on the internet.please sir can I give you a call

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Hi @godsown,

This is a very artificial system, 100 mosquitoes were fed on HBV+ blood and then left exposed to the abdomen of these tiny tree-shrews (less than 200g each) for 20 minutes. This was repeated twice with most animals. Even then only 9/37 animals showed any signs of infection, about half it was very acute, resolving within 2 months.

It’s not clear how this situation can really be extended to the human case, but does suggest that it is a pretty inefficient way of transmission.

Thomas

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86

Thanks sir.i’m calm atleast now

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Hello, I’m a nurse and a week ago, I had encounter an emergency, wherein we deliver the baby in the emergency room, so after normal delivery we dry the baby using clean towel, after that I removed my gloves and wash my hands. But then my co nurse left the baby without clothes on, so I put clothes on the baby without wearing gloves. I don’t know the HEPA b status of the mother, so my question is, is it possible that I get HEPA b by handling the baby with out gloves ( the baby is clean without visible blood on the body ) my hands are a little bit dry and flaky that time.

Hope you could answer, I will appreciate it! Thank you!

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