Who is at Risk for Hepatitis C?

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

The hepatitis C virus (HCV) is transmitted through exposure to infected blood. Certain groups of people have a higher risk of getting HCV than others. A person’s risk is determined by how likely it is for them to come into contact with HCV-infected blood.

Older people, specifically those of the Baby Boomer generation, were once the most likely to have HCV. Part of the reason may be that there were different medical equipment cleaning processes. Plus, blood transfusions that pre-dated current screening standards for donated blood infected some people.1-5

Today, a large portion of new HCV infections are among younger people, especially those born between 1981 and 1996. This may be related to the opioid epidemic.1-5

People more likely to be infected with hepatitis C include:1-5

  • People who inject drugs
  • Babies born to mothers with HCV
  • Baby Boomers
  • Healthcare workers
  • People who received a blood transfusion or organ transplant before the early 1990s

People who inject drugs

Injection drug use is currently the most common reason behind HCV infection. Doctors believe more than half of all people who inject drugs may have HCV. The risk of HCV transmission comes with sharing supplies, specifically unsterilized supplies. This includes sharing needles and syringes.1,2

Sharing other equipment used to prepare and inject drugs may also lead to HCV transmission. This includes sharing cookers, cottons, alcohol swabs, ties, and more. HCV can live on surfaces and equipment for weeks, even when blood drops are too small to see.1

Babies born to mothers with HCV

HCV can be transmitted from mother to child during childbirth. This is called vertical transmission. As many as 6 out of every 100 babies born to a mother with HCV will get the virus. The risk is highest for babies born to mothers with a high viral load. Viral load refers to the amount of HCV in the blood. This risk increases if the mother has HCV and HIV (human immunodeficiency virus) at the same time.2,3

Baby Boomers

Baby Boomers have long been a higher risk group for HCV. Baby Boomers are people born between 1945 and 1965. Although this is changing, until recently Baby Boomers were 5 times more likely than any other group to be diagnosed with HCV. This may be due to injection drug use in the 1970s and 1980s, blood transfusions before the 1990s, differences in the way medical equipment was sterilized, and more.4,5

Healthcare workers

Healthcare workers are at risk for HCV through exposure to contaminated equipment. An example of this is an accidental needle stick. If a healthcare worker is stuck with a needle that was used on a person with HCV, the virus may be transmitted.2

Unsafe blood transfusion or organ transplant

Before the 1990s, blood products and transplanted organs were not tested for HCV. There was a larger risk of getting HCV during these procedures. The risk was especially high for people with chronic medical conditions that required regular blood transfusions.

However, since the early 1990s, blood products and transplanted organs undergo significant testing. Now, the risk of getting HCV from these procedures is nearly zero.2,5

Other health risks

There are other, more rare actions that increase a person’s risk for HCV. Several include:2,5

  • Sharing items that may come into contact with blood, like razors or toothbrushes
  • Having sex with a person who has HCV
  • Having sex with multiple partners (especially men who have sex with men)
  • Getting a tattoo or body piercing at an unregulated business
  • Receiving long-term hemodialysis
  • Being jailed

In addition, people with HIV are at higher risk of also having HCV. People who have an unexplained chronic liver condition or elevated liver function test results may also be at risk.2

It is possible to be re-infected with HCV after treatment. People who have been treated for HCV but who come into contact with the virus again are still at higher risk.1-5

Getting tested

The Centers for Disease Control and Prevention recommends all adults over 18 be screened for HCV regardless of their health risk. They also recommend pregnant women be screened each pregnancy. If someone belongs to a higher risk group, they may need to be regularly tested.2

The good news is that HCV is curable with treatment. Talk with your doctor if you believe you are at risk or think you should be tested.

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