If hepatitis B is sexually transmitted, how come my partner isn’t infected?
This is possible, and not an uncommon scenario. There are several factors that may lead to this situation.
Hepatitis B Virus (HBV) viral load of the partner living with hepatitis B may be undetectable. The lower the viral load in the blood of an infected individual, the less infectious they are. The likelihood of transmitting hepatitis B virus increases with higher viral loads (HBV DNA). Please discuss with your doctor the benefits of antivirals in lowering viral load and potentially reducing the risk of transmitting hepatitis B.
Type of sexual activity is another important factor. There are sexual activities that are associated with higher risk of hepatitis B transmission than others due to the potential exchange of infected fluids (blood, semen and vaginal fluids). For example, anal sex is considered the highest risk sexual activity followed by vaginal intercourse. Oral sex and deep kissing have been reported to be less risky interactions in transmitting HBV. However, any activity that might involve abrasions or trauma may put a person at higher risk of transmission (consider the idea of bleeding gums or cold sores). If you have multiple partners or your partner is in the process of being vaccinated, condoms and dental dams are always recommended to reduce risk of transmission.
Timing of sexual activity may also play a role as sexual activity during the menstrual period poses higher risk of blood contact if the menstruating person is infected. This is why the use of dental dams or condoms is recommended.
Your partner’s hepatitis B status. Your partner may have a current hepatitis B infection, resolved a previous infection, or may have been vaccinated in the past as a child. This is why, the hepatitis B three- test panel (HBsAg, HBcAb total and HBsAb) is standard practice for screening to best understand one’s hepatitis B status. Please encourage your partner to consider the hepatitis B vaccine series if their screening reveals that they are susceptible. The hepatitis B vaccine is safe, effective, and provides lifelong protection.
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Page updated 12/27/2022