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How Do People Get Hepatitis C?

The hepatitis C virus (HCV) is spread through contact with infected blood. Some people are at increased risk for hepatitis C, including:

  • Persons who have ever injected illegal drugs, including those who injected only once many years ago
  • Recipients of clotting factor concentrates made before 1987
  • Recipients of blood transfusions or solid organ transplants before July 1992
  • Patients who have ever received long-term hemodialysis
  • All persons with HIV infection
  • Persons who have used snorting drugs (e.g., cocaine) due to blood on shared straw or bill
  • Persons with known exposures to HCV, such as:
    • Healthcare workers after needlesticks involving HCV-positive blood
    • Recipients of blood or organs from a donor who later tested HCV-positive
  • Patients with signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)
  • Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before 18 months)

Key routes of transmission are discussed in further detail below. Because hepatitis C is often not detected for many years after infection, it may be difficult to pinpoint the exact event that caused your infection.

Injection Drug Use: Past sharing of needles for injection drug use is the most common cause of new hepatitis C cases in the United States, accounting for over two thirds of all new diagnoses. People can even become infected through occasional experimentation with injection drugs or even one-time use.

Blood and Blood Product Transfusions: Before 1992, tests for detecting the hepatitis C virus in donated blood were not available. Many infections resulted from transfusions of donated blood.

Needlestick Accidents Among Healthcare Workers: Infection from injuries while handling hypodermic needles, blood collection needles, and needles used to connect intravenous (IV) delivery systems.

Other Blood-to-Blood Contact: Any other activity that involves blood-to-blood contact may allow for the transmission of hepatitis C: acupuncture, body piercing, and electrolysis or tattooing with improperly sterilized needles or contaminated inks. In addition, the virus may be spread by sharing certain personal-care items (razors, toothbrushes, nail clippers, or nail files) that have blood on them.

For hepatitis C, the risk of transmission through sexual activity is thought to be quite low: less than 5% for partners of hepatitis C-infected persons in a monogamous relationship.

The CDC (Centers for Disease Control and Prevention) has confirmed that hepatitis C is not spread through any of the following: breast-feeding, sneezing, hugging or kissing, coughing, sharing eating utensils or drinking glasses, food, water, or casual contact.

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