Hepatitis C Transmission and Risks


Hepatitis C (HCV) is transmitted when the blood of an infected person passes into the blood of an uninfected person. Hep C is most easily spread through direct blood-to-blood contact, such as:

  • Sharing needles and other equipment (paraphernalia) used to inject drugs. Injection drug users (IDUs) who share needles, syringes, and paraphernalia associated with it are at the highest risk of HCV.
  • Blood transfusions and organ transplants before July 1992. Widespread screening of the blood supply in the United States began in 1992.
  • Sexual contact with someone who has HCV. The risk of becoming infected with hepatitis C through unprotected sexual intercourse is low-but it is still possible. HCV sexual transmission risk is higher among those who are HIV-positive and in men who have sex with men (MSM). Sex with multiple partners, having a sexually transmitted disease, and rough sex may increase the risk of transmitting HCV sexually.
  • Having an HCV-positive mother. Women who are infected with hepatitis C have a 6 percent chance of passing the virus along to their babies during pregnancy or delivery. The risk increases if the woman has HIV, hepatitis B or a high HCV viral load (the amount of HCV in a measurement of blood). The HCV transmission risk is doubled or tripled in women with HIV. It is unlikely that HCV can be transmitted through breast-feeding or breast milk.

Three out of four people with chronic HCV were born from 1945 through 1965. Baby boomers are five times more likely to have hepatitis C than adults born in other years are. The CDC recommends that people born in those years get a one-time blood test for hepatitis C.

Risk Factors

You may be at risk for hepatitis C and should contact your health care provider for a blood test if you:

  • Were born from 1945 through 1965, regardless of any other HCV-related risk factors
  • Were notified that you received blood or an organ from a donor who later tested positive for hepatitis C
  • Have ever injected illegal drugs, even if you experimented a few times many years ago
  • Received a blood transfusion or solid-organ transplant before 1992
  • Received a blood product for clotting problems before 1987
  • Have HIV
  • Have ever been on long-term kidney dialysis
  • Have evidence of liver disease (e.g., persistently abnormal liver function tests)
  • Have an HCV-positive mother
  • Have been exposed to HCV through your occupation (Note: The risk to health workers of acquiring HCV following a needlestick injury is quite low, averaging 1.8 percent)

Other situations where the risk is uncertain, but you may be at risk for HCV if you:

  • Have ever gotten a tattoo or piercing in a non-professional setting where equipment such as ink, inkwells or needles were used and potentially unsterilized
  • Have had multiple sexual partners or sexually transmitted diseases
  • Have ever inhaled cocaine or shared other non-injecting drugs

HCV is not transmitted by casual contact such as coughing, kissing, sneezing, or sharing food, beverages or utensils.

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