Who is at Risk for Hepatitis C?

Hepatitis C (HCV) is caused by a virus that is passed along from one individual to another via blood. So, your risk for getting HCV increases if you are exposed to blood in which HCV is present. 1

High risk behaviors and activities

Factors that increase risk for getting HCV include2,3:

  • Injection drug use (current or past) where needles, syringes, or other equipment that comes in contact with blood is shared
  • Working in a healthcare setting and having a needlestick injury involving exposure to blood from someone with an HCV infection
  • Being born to a mother who is infected with HCV
  • Having a blood transfusion or a solid organ transplant before July 1992 (before the HCV screening test became available)
  • Receiving blood or an organ from a donor who was positive for HCV
  • Having HIV infection

Other possible risk behaviors or activities

Other factors that may possibly increase risk for getting HCV include:

  • Sharing personal care items, such as razor or toothbrush, that have come in contact with the blood of someone who is infected with HCV
  • Having sex with a person who is infected with HCV

Injection drug use is the most prominent risk factor

Results from one large study conducted in the US confirmed that injection drug use was the most prominent risk factor for getting HCV. Injection drug use increases risk of HCV infection by almost 50 times compared with non-injection drug users. Factors that increased risk to a lesser degree included having a blood transfusion (before 1992, when blood screening was instituted) and having sex with an intravenous drug user. As shown in the graph, other factors, such as having spent time in jail and having been stuck or cut with a bloody object, were associated with a much lower risk of acquiring HCV. 4

Baby Boomers and veterans

Baby Boomers (persons born between 1945 and 1965) as a group, regardless of prior exposure or risk, are considered at increased risk for acquiring HCV. Rates of HCV for this age group are 5 times higher than those compared with adults born in other years. Additionally, veterans, particularly Vietnam-era veterans, appear to have a higher rate of HCV than the general public.1,5

Can you get HCV from piercing or tattooing?

Body art including tattooing and body piercing have become very popular in recent decades. A few studies have found that there is low risk of getting HCV when you have a tattoo or piercing done at a licensed, regulated business where infection control practices are followed. However, in unregulated settings where there are limited infection-control practices (e.g., use of non-sterile needles or other instruments), such as in prison or in an unlicensed business, the risk of contracting HCV and other infectious diseases increases substantially. 3

Who should be tested for HCV?

HCV testing is recommended for selected groups of people based on age, prior exposure to HCV, history of high-risk behaviors, and medical conditions. In 2012, the Centers for Disease Control and Prevention (CDC) recommended one-time HCV testing for all persons born between 1945 and 1965, regardless of prior exposure or risk. This expanded earlier risk-based guidelines for HCV testing. According to CDC guidelines, HCV testing is recommended for6:

Persons born between 1945 and 1965 (Baby Boomers)

Persons with a history of risk behaviors:

  • Injection-drug use (current or lifetime, including those who only injected once)
  • Intranasal illicit drug use

Persons with risk exposures

  • Long-term hemodialysis
  • Having a tattoo in an unregulated setting
  • Healthcare, emergency medical, and public safety workers with needlesticks, sharps, or mucosal exposure to HCV-infected blood
  • Children born to HCV-infected women
  • Prior transfusion and transplant (organ) recipients, including:
  • Those who were notified of having received blood from a donor who tested HCV-positive
  • Those who received a transfusion or blood components, or had an organ transplant before July 1992
  • Those who received clotting factor concentrates produced before 1987
  • Those who were ever incarcerated

Persons with selected medical conditions:

  • HIV infection
  • Unexplained chronic liver disease, chronic hepatitis, including elevated alanine aminotransferase levels

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Written by: Jonathan Simmons | Last reviewed: March 2015.