Chances of Transmission: Not Zero
Last updated: April 2022
I have heard a lot of questions over the years about how we can be exposed to hep C. Risk is the word that is most often used to describe how we can be exposed.
As you can imagine, there have been many variations in how people feel and think about their risks or the risk of others being exposed who make up family, spouses, partners, and strangers.
Some of the questions I have fielded over the years, on the surface, may appear to be confused. That is never a sentiment we can entertain because it quite often is an illustration of the degree of anxiety/worry a person is experiencing.
There is nothing silly about fear and anxiety. We hope to alleviate fear and anxiety around transmission, not to mention all the other scary parts that often accompany hep C.
Unfortunately, we see and hear incorrect information that can heighten fears. Online is generally where people get inaccurate information but there is also a lot of good stuff, too.
Transmission of hep C from one person to another
The most common transmission mode now is through substance use. Not every place has harm reduction services crucial to slowing the spread of infectious viruses, like hep C, not to mention increased overdoses with the toxic illicit drug supply.
Injection substance use is still the main transmission route; with increases in smoking of substances people are using is a transmission route when pipes are shared. Providing safe ways that people can use these substances, stigma-free and safely, is without question the best path forward.1
Accessing harm reduction services can be a positive step for those needing health care, including treatment for their substance use disorder or any other medical support.
These modes of transmission are the most common in high-income countries and more and more in some medium and low-income countries. Having said that, it is not the only mode, and we cannot ignore this reality.1
Low risk does not mean no risk.
Sexual activity is a risk, but that does not mean zero risk. Medical care with un-sterilized or re-use of medical or dental equipment is a risk, and when blood is present it is elevated.2
Exposure and the possible risk
Basically, in any setting where there can be exposed via blood-to-blood contact, there is some risk. I recently had a question about a child using Dad’s toothbrush, and Dad was known to have hep C.
My response was that it is very low risk, but that is not zero risk and recommended when they should consider testing the child. As I mentioned, I have heard an array of questions about hep C transmission, and when it is clearly a very low risk, I make sure they understand that low is not zero.
Getting the test done is a good plan. If for no other reason than peace of mind, which has great value too.
We need to remember that hep C is not passed easily in the general population, otherwise, we would all have it. But there are some of us who do have an elevated risk of exposure.
If we ever hope to eliminate hep C we need better harm reduction, testing, and safe and easy access to care and treatment.