Hi everyone,
I am a 21 year old female who recently got into my first relationship with my boyfriend. I have had chronic hep b from birth and started taking Entecavir this past June 2024 to get my viral load down. I disclosed to my boyfriend and he checked that he got the vaccine as a child. Since I am on medication and he was vaccinated, we had sex with a condom and I gave oral sex without a condom.
He recently did the antibody test and found out that the vaccine did not work for him. I am wondering the likelihood that he could have been at risk of getting hep b from what we’ve done. It’s also a stressful situation because now our intimate relationship is up in the air, and since we are both graduating soon, our time together is already feeling pressed.
He has an appointment soon to get the vaccine again but I know that the standard 3 doses can take 6 months. I did some research and found the 2 dose option that would take 2 months and the 4 dose accelerated option that happens in one month with a follow-up booster after a year. With the 4-dose option, would he be able to test antibodies before the post-year booster? What is the earliest he could test for antibodies if he did the 2 dose? I also am wondering how effective each of these vaccines are for him since he was not responsive to the standard one during childhood.
I am also curious to know about what is safe for us to do and what is not at this time. My doctor told me that by taking Entecavir I could get my viral load down to undetectable. What is the likelihood of transmission if he doesn’t yet have the antibodies for hep b? I would love some advice about how to navigate this situation.
Also for reference, my Hep B DNA went from 506,000,000 IU/mL down to 41,600 IU/mL from April (before entecavir) to September (after being on entecavir for 3 months). I’ve now been on the medication for 8 months.
Hi @elderberryblu,
I hear and see you. I bet this has been a nightmare for you. Don’t overstress yourself; remember to breathe. I doubt there is any risk since you had protected sex. Giving someone oral sex leading to transmission will mean a lot has to happen like you having blood in your mouth and him having a cut somewhere. This makes situations like this less likely a source of infection. What are the chances that both things occur at the same time? Even though you still have a high viral load, I think it is less likely for him to get exposed through oral sex.
Hindsight they say is 20/20; maybe he could have checked his antibody levels when he looked into his vaccination. That is all in the past now. It is good that he is on top of it and getting things checked right away.
I have not heard about a 4-dose vaccination. I knew about 2 and 3 doses. If he can get the 2 doses and maybe receive antiviral treatment for post-exposure prophylactic for a short period that is an option.
I will recommend practicing safe sex and avoiding anything unsafe or risky that could lead to exposure. It was smart that you guys used protection.
You should allow each other space to process this if needed. Understand if he needs some time to think, please do not try to force him to talk about this issue if he is not up for it. I bet you feel helpless and concerned, but there is not a lot you can do other than be supportive and patient with him. Let him know you are there if he needs to talk. I don’t know if you have an appointment with your doctor coming up, but it might be a good idea to have him tag along so his concerns can be addressed. You can both talk to a public health expert with HBV knowledge to provide some guidance if that is an option. It is a challenging situation and time will help. Please take care of yourself as well, do not blame yourself for this. Remember to breathe and do not blame yourself for this. Bansah1
What have been your symptoms with such high viral load before medication?
Secondly how long have you lived with the virus?
Mine is 1600 but am much scared.
Thanks
Hi Bansah1, thank you for your response. I appreciate your insight and empathy. I know that the vaccination series plus testing for antibodies can take a while. I guess I am worried about how we can continue our intimate relationship during this period of time. Is safe sex (using a condom and not doing anything risky) enough to protect before it’s confirmed that he has the antibodies? Of course, it heavily depends on his comfort level with everything but I am just curious if me being on medication plus safe sex is enough precaution without his confirmed antibodies.
Since your viral load is still high 40k plus, I think it is risky without any protection. Protection and avoiding other risky behavior should be a must until he has antibodies or your viral load drops to lower or undetectable levels.
It’s also possible for you two to show love and affection towards each other without necessarily having sex. I will not recommend sexual activity without complete protection. It’s up to you both to decide what is right and good for the relationship. I hope this helps. Bansah1