Hepatitis B Transmission Risks and Prevention Strategies

Q: Hepatitis B Transmission Risks and Prevention Strategies

Hello： Hepatitis B is transmitted through the entry of blood or bodily fluids containing the Hepatitis B virus into the body via the skin or mucous membranes. <br>Transmission routes include blood transfusions, injections, hemodialysis, acupuncture, tattoos, eyebrow tattoos, ear

Hepatitis B-related issues

Hello, Doctor.
I recently learned that a family member is a carrier of hepatitis B.
I haven't had a health check-up in over a year and I'm not aware of the viral load or other conditions; I only know that I have fatty liver.
However, I do not have hepatitis B antibodies.
I was vaccinated as a child, but that immunity has likely waned.
This family member often takes and uses other people's belongings without permission; I recently discovered that they used my mouthwash cup and toothpaste.
Although I don't have direct evidence, I have suspected several times that my toothbrush might have been used without my knowledge.
It's been a while since my belongings were used without consent, and the other person doesn't recall if they bled while brushing their teeth.
I have several concerns that I would like to ask about:
1.
Why is there no risk of transmission from sharing food or utensils, but there is a risk from sharing a toothbrush? Is it because the viral load in saliva is lower, but brushing may cause bleeding, which has a higher viral load in the blood?
2.
Can sharing toothpaste lead to hepatitis B infection? (I'm unsure if brushing would cause bleeding.)
3.
If there are wounds in the mouth and saliva from a person with hepatitis B is ingested, is there a risk of infection?
4.
How long can the hepatitis B virus survive outside the body in a general environment?
5.
Is the risk of infection high if a small amount of blood enters a minor wound?
6.
Can the virus move? For example, if a drop of blood falls to the ground, can the virus leave the blood and spread around?
I got vaccinated as soon as I learned about my family member's hepatitis B status (about a week ago), but I didn't think of these concerns at that time.
The doctor advised me to check for antibodies and antigens about a month after vaccination, so I haven't had a blood test yet.
However, I am someone who frequently gets mouth sores and often has wounds in my mouth.
I was previously told during a health check-up that my liver was not in good condition, and this situation is making me increasingly anxious.
Thank you, Doctor.

Amy, 20~29 year old female. Ask Date: 2023/08/02

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: Hepatitis B is transmitted through the entry of blood or bodily fluids containing the Hepatitis B virus into the body via the skin or mucous membranes.
Transmission routes include blood transfusions, injections, hemodialysis, acupuncture, tattoos, eyebrow tattoos, ear piercings, sharing toothbrushes or razors, and sexual contact.
Carriers may have the Hepatitis B virus in their vaginal secretions, saliva, and semen, but this typically does not lead to infection; however, high viral concentrations can still pose a risk.
In response to your question: if you come into contact with blood or bodily fluids containing the Hepatitis B virus and have an open wound, there is a chance of infection through mucous membranes.
Blood droplets on the ground do not cause the virus to spread everywhere.
There is no need to worry too much; at 21 years old, you should have received the three doses of the Hepatitis B vaccine, which provides protection, and you have received a booster.
Having received the vaccine, a negative Hepatitis B surface antibody test does not mean that vaccine protection has disappeared.
If you have received a booster and your antibody levels rise quickly, it indicates successful reactivation of immune memory, which can help combat Hepatitis B infection.
Wishing you good health!

Reply Date: 2023/08/02

More Info

Hepatitis B (HBV) is a significant public health concern, particularly for those who may be at risk of transmission through close contact with infected individuals. Understanding the transmission risks and prevention strategies is crucial, especially when you have a family member who is a carrier of the virus. Let's address your concerns systematically.

1. Transmission through Shared Items: The primary mode of transmission for Hepatitis B is through blood and bodily fluids. While sharing food and utensils does not typically pose a risk, sharing toothbrushes can be dangerous. This is because toothbrushes can harbor blood if there are any cuts or abrasions in the mouth. Saliva does contain the virus, but in much lower concentrations compared to blood. Therefore, the risk of transmission is significantly higher when blood is involved, such as through a toothbrush that may have come into contact with blood.

2. Sharing Toothpaste: Sharing toothpaste itself is unlikely to transmit Hepatitis B. The virus is not transmitted through saliva in the same way it is through blood. However, if there is any bleeding during brushing, there is a potential risk if the toothbrush has been contaminated with blood from an infected person.

3. Open Wounds and Saliva: If you have an open wound in your mouth and come into contact with saliva from someone who is infected with Hepatitis B, there is a risk of transmission. The virus can enter the bloodstream through the wound, especially if the saliva contains a significant viral load.

4. Survival of the Virus in the Environment: Hepatitis B virus can survive outside the body for at least 7 days, depending on environmental conditions. This means that if blood containing the virus is left on a surface, it can remain infectious for a week. This is why it is crucial to clean any surfaces that may have come into contact with blood.

5. Infection Risk from Small Amounts of Blood: The risk of infection from small amounts of blood entering a small cut or abrasion is significant. Even a tiny amount of blood can transmit the virus if it contains a sufficient viral load. Therefore, it is essential to avoid situations where blood from an infected person can come into contact with your skin or mucous membranes.

6. Movement of the Virus: The virus itself does not "move" in the sense that it can travel independently. However, if blood containing the virus is spilled, it can contaminate surfaces and remain infectious for a period. It is crucial to treat any blood spills with caution and proper cleaning protocols.

Given your situation, it is wise that you have already taken the step to receive the Hepatitis B vaccine. Vaccination is the most effective way to prevent infection. After completing the vaccination series, it is recommended to have your antibody levels checked to ensure that you have developed immunity.

In your case, since you have a history of oral sores and potential exposure to the virus, it is advisable to maintain good hygiene practices, such as not sharing personal items like toothbrushes or razors. Additionally, if you have any concerns about your liver health, it would be prudent to consult with a healthcare provider for regular monitoring and possibly further testing.

Lastly, managing anxiety regarding health concerns is important. Consider discussing your worries with a healthcare professional who can provide reassurance and guidance tailored to your specific situation. Regular check-ups and open communication with your healthcare provider can help alleviate concerns and ensure that you remain healthy.

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