Frequently worrying about transmission

Living With Hep B
1

Hi Sir,

Im frequently worrying about the transmission.

  1. Wound and bathing

When I have a wound, I cover it with a bandage. After some time it becomes a scab. I worry that when I take a bath, the water from scab touch other parts of my body and that I might transmit the infection to my daughter if she has small abrasions unknowingly or randomly

Does scab transmits virus

  1. Sweating in summer

In summer everyone sweats a lot. I worry that if I sweat and go near my daughter, the infection might spread to her.

Im not at all kissing her for long time it’s very very painful because I feel saliva can spread the virus.

Can I kiss her even my viral load is 88000

  1. Viral load fluctuations

My viral load was first 1,328. I am HBeAg negative and anti-HBe positive. Later my viral load changed to 21,000, then 10,000, then 76,000, then 19,000, and now 88,000. Why is it fluctuating? Has the virus mutated? Im not taking any medication

  1. Vaccination question

My wife recently completed three doses of the vaccine. My daughter has an anti-HBs level of 13. Should she get a booster dose? She recently took antibiotics for 10 days because of a health issue

2

Hi @Rajesh_Raj,

  1. A scab should not be able to transmit the virus if it’s not bleeding anymore. You are doing the right thing by bandaging cuts. Also, when you are taking a bath/shower, standard soap should be enough to inactivate the virus. I wouldn’t worry about this.
  2. The virus is not transmitted through sweat or through hugging or kissing. There should be no risk of transmission in this case.
  3. Interesting. Generally, people who are HBeAg negative have low DNA, however yours is quite high. It is certainly possible that the virus has mutated. This happened to me. My genotyping said that I have a precore mutation, which allows the virus to replicate without HBeAg. The good news is that it hasn’t affected the efficacy of antiviral treatment for me. I’m actually very curious to know what your ALT/AST levels are. From what I’ve read, people whose viral DNA fluctuates as much as yours is tend to have fluctuating ALT and AST as well. If this is the case for you, then you should definitely talk to your doctor about treatment options.
  4. 13 is still considered protective, though it’s only slightly above the threshold. I don’t think it would hurt to get her boosted, especially if it’s been more than 10 years since the initial vaccine series. I would also recommend that your wife get tested in a few months time to see if she has developed sufficient antibodies to the virus.

Hope this helps.

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Hi @Rajesh_Raj,
@et5656 is right. I would like to add to that. With your viral load fluctuating back and forth, I strongly recommend that you speak to your doctor and discuss the possibility of treatment. Additionally, anti-HBs of 13 is still considered high and offers protection. Protection is considered not high if it is below 9 IU/ml. You may speak with her doctor and discuss this further, whether a booster is a great idea for your family. Your wife’s anti-HBs can be measured in about 3 months.

Your daughter’s antibodies are high enough, so any transmission with her is less likely. However, because your wife just got vaccinated, please keep taking care of any wounds and clean up after yourself if you cut yourself until there is lab evidence that she has developed antibodies. You can kiss your daughter on her cheeks if that helps and makes you more comfortable.

I hope this helps. Best, Bansah1

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