While it’s possible, however, it’s less likely for that to occur given the undetectable viral load in your case. I hope this helps. Bansah1
@ThomasTu @john.tavis I was reading some messages from mr availlant. @availlant as mr availlant said that hbsag is a viral sub particle which is non incectous. So again i am asking how is it possible that hbsag(which is non infectous)<1000mIU/ml and dna viral(which is infectous) is not detected in blood can transmit the infection to others by blood?
In hepatitis B infection, surface antigen plays no role. Rather surface antigen is a measure useful in treatment management to see whether someone is cured or benefiting from treatment. A higher or lower surface antigen doesn’t impact infection risks to others.
A lower or undetectable viral load means less risk of transmission to anyone. You are less likely to infect someone if your viral load is undetectable. This changes when there’s an increase in viral load say during a flare up, then the risk of infecting others could rise.
I hope this is helpful. Bansah1
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@john.tavis @Bansah1 @ThomasTu i am assuming some scenarios and want to not how to manage these conditions as i am CHB positive:
Scenario 1: if i dont know that i have a acne on body and some of the blood from that acne is coming without noticing. And by mistake i touch that blood and then after touch someone’s eyes or mouth(which have mucous membrane) in the family of friends, is there any chances of spreading the virus?
Scenario 2: if i am going in a car with friends and dont know that all of the persons are vaccinated or not. By mistake if i get any injury or cut so washing it with water only will be helpful or not as no one carries soap in car(lets assume its my friend’s car). Also lets think if my friend has a cut and by mistake i touch his cut or eyes or mouth after washing my hand with water only (which is having cut) what is probability of infecting them and of course i cant tell everyone that i am hep b positive.
I think Washing the cut with water only will not leave virus infectous because after washing with water only will dilute the concentration of virus.Am i right? Need your expertise.
Thanks
It’s difficult to say yes or no in either scenarios. However, what i will say is that just because there is a cut and blood doesn’t mean who ever you touch or touches you will be infected. There will be a transmission only if your blood finds its way into their bloodstream if say they also have a cut or skin opening. As you can tell these make the chances less likely. What is the probability that the moment you have your cut the person next to you has a wound or opening, and you will touch them with the bloody hand which will lead to an infection? While this can happen, the possibility are very slim.
Practicing good hygiene such as frequent handwashing, bandage any wound or cut, use hand sanitizer if water and soap is not available, and being extra careful will go a long way. As a practice i have a bottle of hand sanitizer in my car at all times so I can use when I get in my car from the store, doctors offices, or public spaces before driving.
I hope this is somehow helpful.
Some more questions
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first one is about mucous membrane. No cut, no wound if little blood go into mucous membrane, can it infect
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if blood on hand washed by water only then the washed hand can cause infection? Because i am thinking technically by water blood will be diluted so there is no risk of infection as the concentration of virus is diluted?
Please advice
If the mucous membrane is intact, I doubt that it will lead to an infection. I don’t know the exact answer to that question.
Washing your hands with water and soap is the most effective way to neutralize viruses that are on your hands. Proper hand washing could reduce infections (water and soap). I doubt water alone is powerful if there is blood.
While hepatitis B is very complex, there is no evidence that someone got infected through what you are describing. The majority of hepatitis B infection happens during the birthing process when an infected mother passes the virus on to her baby. Sexual transmission via unprotected sex with an infected person, sharing needles for drug use, toothbrushes, tattooing, and sharing sharp objects are among the most common routes of hepatitis B infection. Thanks, Bansah1
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@Bansah1 @ThomasTu @john.tavis @availlant @et5656 i respect the way you answer and try to distribute knowledge. But i think there is a technical glitch which i think we should discuss more until we get the right technical answer.
@Bansah1 “I think you did not get my question. I want to compare between saliva(as we have been told which has little virus only) and washed hand with water only (which has no visible blood so that there would be also little virus on washed hand). Then why is it said that salvia alone cannot spread infection( as the concentration of virus is very low) but washed hand with water only( which also has no visible blood after washing with water only so that it also has very low concentration of virus) can spread infection? I know that washing hand with soap and water will be more effective. But we have always been told that if no visible blood then there is no risk. So the salvia without blood and washed hand which has no visible blood should have the same scenario of not spreading virus because both has low concentration of virus.” Then why it is said after any blood on hand or on other parts of body we must wash it with soap and water to destroy the virus completely which i think should not be remained infectious if we wash it with water only because of no visible blood after washing so that no more high concentration of virus.
I request all respected members to put their efforts in answering the questions so that i can also improve my knowledge and hygiene habits. As we all are on this forum to support each other to solve the doubts by experts advice.
Thanks
Hi @Rohit,
Thanks for sharing your story and your worries with us.
We have addressed many kinds of these questions in other threads (e.g., Transmission risk by accidentally touching blood? - #25 by Caraline , As a football player positive for Hepatitis B, I wish to know if playing football puts my teammates or opponents at risk through body contact , Can I Play Football With My Peers? - #3 by Kiowa6530 ). We also know that it’s such a common fear people have of hepatitis B that we developed an entire awareness campaign around it: https://www.livewellwithhepb.com.au/
Essentially from everyday contact and interactions, there’s little risk of transmission.
Thomas
@ThomasTu @john.tavis @Bansah1 i read all the links provided by you but did not get my answer.
I am only stuck on this point. Could you please write your answer as per your technical knowledge?
Question: Saliva alone contains no risk in daily life in spreading hep b infection as saliva contian very low amount of virus. So we have been told that saliva is non infectous until there is no visible blood. If we think for example, blood on hand and we wash it water until there is no visible blood after washing then there should be low concentration of virus on that site after washing. So theoretically both saliva and washed hand have no visible blood so that concentration of virus is low in both scenarios. Then Why we have been told that saliva alone is non infectous but washed hand with water only can spread infection?
Kindly help to provide your words on this point.
Hi @Rohit,
The discrepancy that you highlight is primarily due to treating a complex situation as a black-and-white, yes-no, situation. In both cases, the key is the amount of virus present.
The hand-washing scenario you discuss presumes the original presence of a large amount of blood with high viral levels. In that case, just washing with water is insufficient because there was a large amount of virus to start with and it was just rinsed off with water, which does not destroy the virus like soap does. On the other hand, unless there is a cut or other trauma to a person’s mouth, the amount of blood present is very, very small. Add to that the fact that saliva contains digestive enzymes that can damage HBV and that saliva is constantly being swallowed (in effect rinsing the mouth out), you get to the situation where the amount of virus potentially present in saliva is too low for infection.
John.
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Hi @Rohit from your previous message, with HBsAg around 5,000, interferon and/or bepi is unlikely to lead to a functional cure for you. Bepirovirsen is not yet approved, but it has only been tested as a 24 week finite therapy, and I have not heard of any studies to assess whether extended treatment, or re-treatment for patients who had a partial response. If/when bepi is approved, some providers may choose to attempt a second round of treatment at their discretion, but honestly I don’t know whether this is any more likely to work than just having one round of treatment.
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Thank you @john.tavis for your excellent explanation. You are one of the wonderful and supportive person on this forum. Respect:)
@et5656 my hbsag is 5000 S/co not 5000 IU/ml
@john.tavis @Bansah1 @availlant It is said that low concentration of virus in saliva. So in daily life our tongue touches our lips so many times while eating, talking, thinking etc. so thinking about a scenario that every time tongue touches lips, will leave some viruses on lips. Lets assume this happens 20 times or more in a day then it will leave so much viruses on lips and if i kiss my child who has an open cut in his mouth or on cheeks which i don’t notice everytime. Can it spread infection?
Because if i want to come back normal in my life then i have to leave thinking about saliva, lips and tongue etc. except blood. Before diagnosis, i just gave him love, kissed him so much(without washing anything) but now the scene is different after diagnosis. So much fear of transmission. Worried for family.
@ThomasTu @john.tavis @availlant waiting for your kind words:)
Dear @Rohit,
Thank you for this question. As mentioned above, there is negligible risk of transmission this way. There is no need to limit your kissing of your child.
The hypothetical scenario you describe would not lead to build up of viruses on the lips, as you would be constantly washing it away as you lick your lips.
The amount of HBV DNA in the saliva is approximately 10-100 times less than in the serum (pubmed.ncbi.nlm.nih.gov), so this further lowers the risk of transmission.
Even if HBV DNA is detected, there is no reason that it is infectious. There are a lot of enzymes in the saliva that break down sugars, proteins, etc. In other bodily excretions (e.g. feces), HBV DNA is detected, but does not contain infectious material (pubmed.ncbi.nlm.nih.gov).
After decades of studies, there has been only a single documented case of enough saliva being conveyed for transmission and this was due to spit in the eye of someone who was unvaccinated (pubmed.ncbi.nlm.nih.gov).
Hope this helps,
Thomas
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