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Can You Get Viral Hepatitis from Oral Sex?

Nicole Cutler L.Ac.

October 9, 2009

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Make sure you know the facts about how oral sex could transmit the three most common types of viral hepatitis. Please note: explicit descriptions of sexual activity are contained within this article.

The education campaign following the AIDS epidemic of the 1980s has made most people aware that unprotected sex can lead to sexually transmitted diseases (STDs). However, stopping our understanding at that point leaves many questions unanswered, especially regarding oral sex. Since viral hepatitis is contagious and has the potential of being an STD, many people are unsure if any viral hepatitis strains can be transmitted through oral sex.

Illnesses like the common cold and flu are primarily spread through respiratory secretions. Thus, our wellness depends on people covering their noses and mouths then washing their hands after sneezing or coughing. However, preventing the spread of respiratory secretions is insufficient to protect against STDs. This is because the viral particles of most STDs are spread through other bodily fluids. This applies to the three most common strains of viral hepatitis:

  1. Hepatitis A is transmitted when infected feces enters another person’s digestive system. There is an effective vaccine to prevent against Hepatitis A infection.
  2. Hepatitis B can be transmitted through contaminated blood, sweat, tears, saliva, semen, vaginal secretions, menstrual blood and breast milk. There is an effective vaccine to prevent against Hepatitis B infection.
  3. Hepatitis C is transmitted through blood when infected blood of one person enters another person’s bloodstream. There is currently no vaccine to prevent against Hepatitis C infection.

Oral sex refers to sexual activities that involve the stimulation of the genitals with the mouth, tongue, teeth or throat. For the purpose of discussing STDs, the three types of oral sex are:

  1. Cunnilingus – this refers to oral stimulation of a female’s outer genitalia.
  2. Fellatio – this refers to oral stimulation of a male’s outer genitalia.
  3. Analingus – this refers to oral stimulation of the anus.

Oral stimulation of other parts of the body is generally not considered oral sex. Those in long-term monogamous relationships who do not have any contagious illnesses have virtually no risk of getting a sexually transmitted disease through oral sex. For everyone else, the risks of STDs are a major concern, and can only be avoided through education, protection and/or abstinence.

The risk of contracting viral hepatitis through oral sex is different for each viral strain:

  • Hepatitis A Risk – The Hepatitis A virus is highly concentrated in the feces. Unfortunately, it will almost inevitably be present on apparently clean anal skin of infected individuals. Thus, there is a substantial risk in acquiring Hepatitis A from analingus. Several epidemic outbreaks have been reported among gay men, but heterosexual couples practicing analingus are just as likely to be at risk.
  • Hepatitis B Risk – The Hepatitis B virus can cause chronic liver disease – and has the potential to be fatal. Considered to be 100 times more infectious than HIV, Hepatitis B viral particles are in semen, vaginal secretions, stool, tears, saliva, sweat and blood (including menstrual blood). There is clear evidence that Hepatitis B can be transmitted through vaginal and anal intercourse, but it is unproven whether it can be transmitted through oral sex. Since it is so contagious, there is a theoretical risk of transmitting Hepatitis B through cunnilingus, fellatio or analingus.
  • Hepatitis C Risk – The Hepatitis C virus can also cause chronic liver disease with a potential for being fatal. Transmitted via blood-to-blood contact, this illness is harder to acquire from sexual contact. While there is little evidence proving Hepatitis C acquisition through oral sex, a theoretical risk exists if there is any blood present in the giver or receiver. Thus, a risk of transmitting Hepatitis C via cunnilingus, fellatio or analingus exists if there is any menstrual blood, bleeding gums, a throat infection, cold sores, canker sores, genital warts, hemorrhoids or any other breaks in the skin in any involved body structure – vagina, clitoris, labia, penis, testicles, anus, perineum, lips, tongue or anywhere else on the genitalia or inside the mouth.

Experts believe that viral hepatitis is more likely to be transmitted if either the positive or the negative partner has another STD, especially one that causes sores or lesions. Thus, suspicious symptoms should always be checked by a doctor before engaging in oral sex.

Besides being vaccinated against Hepatitis A and B, safer sex practices can help prevent the spread of viral hepatitis. Using condoms can prevent disease transmission during fellatio; latex or polyurethane condoms are best for disease prevention since natural skin condoms have small pores that can let viruses through. Latex dental dams, sheets of plastic wrap and latex sheets sold specifically for oral sex can help prevent disease transmission during cunnilingus or analingus.

Although the risk of transmitting viral hepatitis during oral sex is low, practitioners suggest abstaining if there are any cuts or sores on the mouth or genitalia areas. Additionally, some experts suggest avoiding brushing or flossing their teeth right before or after oral sex since these activities may create tiny abrasions or result in bleeding gums.

Vaccinations against Hepatitis A and B can protect you if you’ve been exposed to one of these viral particles during oral sex. However, these vaccines will not protect you from Hepatitis C or any other STD. Therefore, knowing what situations are riskiest, and being prepared to abstain or practice safe sex, is your best bet for engaging in disease-free oral sex.

References:

http://menshealth.about.com/cs/diseases/a/hepatitis_4.htm, How You Get Hepatitis, Jerry Kennard, Retrieved October 1, 2009, About.com, 2009.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/sextrans.pdf, Sexual Transmission of Hepatitis C, Retrieved September 30, 2009, Hepatitis C Support Project, 2009.

http://www.netdoctor.co.uk/infections/infectionoralsex.htm, Infection Risk and Oral Sex, Retrieved September 30, 2009, netdoctor.co.uk, 2009.

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Posted by Nicole Cutler L.Ac. on October 9, 2009

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  • curious

    i have a future partner who has told me thy have hep b but are on meds for it . can i contract it thro oral sex with her

  • mamita

    Im afriad my husband just find out he got hep c i got tested and results where neg can it come out later

    • Ethan Davidson

      Studies of heteroxexual couples couples where one has hep c and the other dosn’t indicate that in most cases there is no transition. Evan in those rare cases where one person does become Hep C positive, it usualy is with a different genotype, indicating a seperate infection source. Thus, we know that sexual transmision of HCV via heterosexual or lesbian sex is extremley rare. There is a small but real rate of transimison amog men who have AIDS and one also has HCV. This cam usually be prevented by barriored “safer” sex.
      However, partners that live together sometimes engadge in intimacies such as sharing razers or tooth brushes, These should be avoided, as should any contact with the infected person blood, whenever possible.
      Doctors have (mostly) reached consensus that couples in a monogoumous relatioship where one is HCV positive do not need to switch to bariored sex unless they are already using it for some other reason.
      It is true that “having a large number of sex paartners) is considered to be a possible HCV risk factor for women. However, They are not sure why. It may be that women who self report “a large number of sex partners” have other risk factors, such as drug use.

  • Shirazi

    hi. My wife has Hepatisis b, but I myself dont. I also had vaccination 20 years ago. my question is that is it possible that I receive this viral disease through cunnilingus? thanks

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