HOW IS HEPATITIS C VIRUS TRANSMITTED?

Hepatitis C virus (HCV) spreads primarily through contact with infected blood. In used syringes, blood contaminated with HCV can be infectious for up to 3 weeks. HCV can survive in dried blood spills for up to 4 days.

HCV is also spread through transfusions of blood and blood products. HCV was not discovered until 1989. Until 1990, there was no way to test blood for HCV. Many people got HCV from blood transfusions or blood products, such as those used by hemophiliacs. In the early 1990s, blood banks began to test for HCV. In the past, kidney dialysis patients also were at risk for HCV infection.

CAN HOUSEHOLD CONTACTS TRANSMIT HCV?

Normal household contact does not spread HCV. It is not transmitted by hugging, kissing, or eating or drinking from a shared glass, fork, knife, or plate.

However, there can be some risk in sharing household items such as shaving razors, nail clippers, and toothbrushes.

INJECTION DRUG USE

The main way HCV is transmitted is through injection drug use. Some studies have found that as many as 90% of people who inject drugs (PWID) are infected with HCV.

Sharing syringes and needles for injection is the riskiest activity for getting and transmitting HCV. You can also get HCV from other drug injection supplies and equipment, such as cookers, cottons, filters, water, and syringes.

Better public access to clean needles reduces the spread of hepatitis. In some states, adults can purchase new syringes in pharmacies without a prescription. Some communities have started syringe service programs (SSPs) to give free, clean syringes and other equipment to people so they won’t need to share and others have established safe supervised injecting spaces. The North America Syringe Exchange Network has a web page listing many SSPs in the U.S.

TATTOOING AND BODY PIERCING

Tattooing and body piercing can transmit HCV if equipment, ink, or even inkwells are shared. These unsafe practices are especially likely if tattoos or body piercings are done on the street or in prison. If you decide to get a tattoo or body piercing, check the safety procedures. These include:

    • Using new needles
    • Sterilizing any tools or materials that might come into contact with blood
    • Disinfecting all work surfaces
    • Using new gloves for each client
    • Using new ink pots for each person (HCV can survive in tattoo ink)
    • Protecting fresh tattoos and piercings so that blood is not transmitted
    • Carefully disposing of everything that might have blood on it

PERINATAL TRANSMISSION

HCV can be spread from a pregnant person to their baby during pregnancy, childbirth, or delivery, although this only happens in about 1 out of 30 cases. This is called perinatal transmission. A baby can also be infected through breast milk if the birthing person’s breasts (nipples) are cracked and bleeding.

HEALTHCARE WORKERS

Exposure to HCV-infected blood can cause infection through any of the following healthcare related exposures:

    • Needlesticks and other sharps-related injuries
    • A patient’s blood comes into contact with an open cut or sore
    • A patient’s blood comes into contact with the eyes

Healthcare workers should follow standard precautions to avoid contact with possibly infected blood.

SEXUAL ACTIVITY

HCV is not commonly spread through sexual activity. However, sexual practices that cause even minor bleeding can spread HCV. Vigorous intercourse, fisting, anal sex, or other activities that draw blood can transmit HCV.

People who have a sexually transmitted infection (STI) such as HIV are more likely to transmit HCV through sexual activity. Open sores, such as those caused by herpes simplex virus (HSV) or syphilis, increase the risk of transmission.

Sexually transmitted HCV is spreading among HIV-positive men who have sex with men (MSM). Risk factors include sharing sex toys, having multiple partners, rougher and longer anal intercourse, fisting, and anal sex after rectal surgery.

HOW IS HCV PREVENTED?

Unfortunately, there is no vaccine to prevent HCV. To reduce your risk of getting HCV:

    • Injection drug use is the most common way people get HCV. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing. Read more about injection drug use guidelines.
    • Avoid sharing personal care items that might have blood on them (razors, toothbrushes, nail clippers).
    • If you are a healthcare or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps.
    • Consider the risks if you are thinking about tattooing, body piercing, or acupuncture – are the instruments properly sterilized?
    • If you’re having sex with more than one partner, use latex condoms correctly every time to prevent the spread of STIs, including HCV.

WHAT IF I’VE BEEN EXPOSED?

HCV might not cause any symptoms. If you think you have been exposed to HCV, talk to your healthcare provider, public health department, or employer and get tested.

THE BOTTOM LINE

The main way hepatitis C virus (HCV) is spread is through contact with infected blood. People who inject drugs (PWID) are at high risk of HCV infection. Tattooing and sexual activity carry some risk of HCV transmission. Pregnant women with HCV can pass the infection to their new babies, although the risk is low (about 3%).

To prevent HCV transmission, do not share injection drug equipment or supplies, avoid sharing personal care items that may have blood on them, make sure instruments are properly sanitized if you are getting a tattoo or body piercing, and practice safer sex. If you are a healthcare worker, follow universal precautions and institutional policies regarding safe use of needles and other sharp instruments.

MORE INFORMATION

CDC: Testing Recommendations for Hepatitis C Virus Infection

National Harm Reduction Coalition: Hepatitis C

National Harm Reduction Coalition: Find Harm Reduction Resources Near You

Reviewed July 2024

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