QUESTION
In January of 2000, I tested negative for STDs. I asked my then doctor about hepatitis vaccinations. He knew I was a sexually active gay man. He discouraged me from the vaccination and said I didn't need it. I am now HIV and HBV positive for antigens. And no, I have never had anal sex without a condom. I'm taking Combivir and Viracept. Is there anything that can be done to help with the HBV now? Is the vaccination for HBV therapeutic in nature?

I'm worried about transmission and want to protect others. I'm starting to date an HIV- guy, and I don't want to hurt him.

ANSWER
Some adults with recently acquired Hep B lose their Hepatitis B antigen over time, making them less infectious. One of the medications in Combivir (lamuvidine) also works against the Hepatitis B virus.

Most liver specialists -- hepatologists or gastroenterologists -- treat chronic active Hepatitis B. While there are no therapeutic vaccines, there are the preventive vaccines, that unfortunately were not made available to everyone at risk. Since 1991 all newborns in the U.S. routinely get Hepatitis B vaccinations.

Hepatitis B is very easily transmitted, much easier than HIV, and can be transmitted by sharing utensils, toothbrushes, razors, etc. Sexual partners of people with chronic Hepatitis B should be vaccinated if they have not been already.

To your health,
Dr. K