Hepatitis C Transmission

Reviewed by: HU Medical Review Board | Last reviewed: August 2021.

Hepatitis C virus (HCV) is a blood-borne virus. When blood that is infected with HCV comes into contact with the blood of someone who does not have HCV, the virus can be spread.

Tracking HCV transmission

Tracking HCV transmission can be difficult for several reasons. First, there is a period of time between exposure and the first time a person will have symptoms. This is called an incubation period. It may take several weeks for a person who is exposed to HCV to have symptoms. If they have had multiple potential exposures during that time, it can be hard to know which exposure led to infection.1,2

Second, most people will not show symptoms right away. About half of all people who get HCV will develop chronic (long-term) infection.3

In these cases, symptoms may not show up for decades. The first signs of HCV may be when a person’s liver has been damaged. This can be years after exposure. Trying to track down an exposure event that may have happened decades earlier can be nearly impossible. In some cases, there is no specific exposure event identified.3

Currently, the most common way HCV is transmitted in the United States is through injection drug use. However, there are many other ways HCV can be transmitted.2

Injection drug use

HCV can be spread by sharing needles, syringes, or anything else used in the process of preparing or injecting drugs. Some estimates suggest more than half of people who inject drugs may have HCV. This number also varies state to state.2

While there is a significant risk of getting HCV through injection drug use and needle sharing, this is not the only method of transmission. HCV can also be transmitted in health centers, during childbirth, through sexual contact, and more.2-5

Mother-to-child transmission

The most common way children get HCV is during birth. Mother-to-child transmission is possible. This is also called vertical transmission. There is about a 6 percent risk of vertical transmission if a mother has HCV. The risk is higher for mothers with higher viral loads. It is also higher for mothers who also have HIV.3,4

Blood transfusions and organ transplants

Before the 1990s, blood products and transplanted organs were not tested for HCV. There was a larger risk of getting HCV during blood transfusion and organ transplant. This was especially true for people who needed regular blood transfusions, such as people with hemophilia or those having long surgeries.2,4

Since the early 1990s, blood products and transplanted organs now undergo significant testing for viruses like HCV. Now, the risk of getting HCV in the US during these events is nearly zero.2,4

Healthcare settings

HCV can also be spread through accidental needle sticks in healthcare settings. If a healthcare worker gets pricked by a needle that had been inserted into a person with HCV, the virus may be transmitted. Although rare, unsafe sterilization practices in medical or dental settings can also lead to HCV transmission.2,4,5

Sexual contact

The risk of transmitting HCV through sexual contact is very low. However, it is possible. The risk is higher for people who also have HIV. It is also higher for men who have sex with men and people who have multiple partners. Exposure to blood during sexual contact can also increase risk. An example of this is having sex during menstruation.2,4,5

Other rare, potential forms of transmission

Although the risk is very low, there are several other ways a person may be exposed to HCV. These include coming into contact with unsterilized tools used during tattooing, body piercing, or manicuring. Another low-risk method of transmission is sharing personal items that may come in contact with blood. These include toothbrushes or razors.2,4,5

HCV is not transmitted by hugging, kissing, or sharing utensils.

If you think you may have been exposed to HCV or are concerned about your risk, talk with your doctor. HCV is curable with treatment.

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