Hepatitis C Transmission: How Hep C Is Spread & Contracted

If you've just been diagnosed with hepatitis C, you may wonder how you got it and worry about passing on the virus to a loved one. If you've had the disease for a long time without knowing it, you could dwell on every little incident in the past where you might have accidentally exposed a family member to the disease.

It's important to remember that hepatitis C isn't easy to catch. If you take a few precautions, it's almost impossible to pass on the disease to someone else.

How Does Hepatitis C Spread?

Hepatitis C is spread only through exposure to an infected person's blood.

High-risk activities include:

  • Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don't share needles or equipment with anyone else.
  • Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
  • Blood transfusions in countries that don’t screen blood for hepatitis C.
  • Nonsterile medical equipment. Tools that aren’t cleaned properly between use can spread the virus.
  • Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.

Medium-risk activities include:

  • Sharing or not disposing of grooming and hygiene supplies. This includes razors, toothbrushes, nail clippers, or anything else that could have your blood on it. Cover any open wounds or sores with bandages. Carefully dispose of tampons, sanitary napkins, tissues, used bandages, and anything else that might have your blood on it.
  • Unprotected sex. It’s rare, but you can spread and catch it from sex, especially during menstruation or certain sex practices like fisting. It’s more likely you’ll spread it if you have HIV or another sexually transmitted infection.
  • Pregnancy and birth. There’s a small risk for a mother to pass the disease on to her child before or during birth. The odds go up if the mother has HIV.
  • Needle-stick injuries. Health care workers and caregivers are most likely to get it this way.

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Things that Don’t Spread Hepatitis C

It cannot be spread through:

  • Coughing
  • Sneezing
  • Hugging
  • Kissing
  • Breastfeeding (unless nipples are cracked or bleeding)
  • Sharing utensils or glasses
  • Casual contact
  • Sharing food and water
  • Mosquito or other insect bites

That means everyday contact isn’t risky. The odds of it spreading between people in a household are near zero.

What Are the Chances of Getting Hepatitis C From Sex?

Hepatitis C can spread through sexual intercourse, but it's rare. And it's extremely rare among monogamous couples. In fact, the CDC considers the risk of sexual transmission between monogamous couples so low that it doesn't even recommend using condoms. Also, there's no evidence that hepatitis C is spread by oral sex. But you should avoid sharing razors, toothbrushes, and nail clippers, and sex during menstruation.

If you have HIV or if you have multiple partners, you should take precautions. Using condoms will protect you and your partners.

Who’s at Risk for Hepatitis C?

You might be more likely to get it if you:

  • Inject or have injected street drugs (even once)
  • Were born between 1945 and 1965
  • Got clotting factor concentrates made before 1987
  • Received a blood transfusion or solid organ transplants before July 1992
  • Got blood or organs from a donor who tested positive for hepatitis C
  • Are on dialysis
  • Are a health care worker who might be exposed to needle sticks
  • Have an HIV infection
  • Were born to an infected mother
  • Are in jail or prison
  • Use intranasal drugs
  • Get a body piercing or tattoo with nonsterile instruments

Can You Be Reinfected?

Yes. If you’ve been infected and cleared the virus, or you’ve been treated and cured, you can get the virus again.

Can You Be a Blood or Organ Donor?

You can’t give blood if you currently have symptoms or have ever tested positive for hepatitis C. But you can probably donate organs or tissue, since risk of transmission is low and hepatitis C is curable.

Encouraging Others to Get Tested for Hepatitis C

While the odds of passing on the hepatitis C virus are low, you should still tell anyone at risk that you have hepatitis C. You should tell sexual partners, spouses, and family members. Your infection may be difficult to discuss, but anyone at potential risk must know. That way, they can get tested and treated if needed.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on December 02, 2018

Sources

SOURCES:

Paul Berk, MD, professor of medicine and emeritus chief of the division of liver disease, Mount Sinai School of Medicine, New York City; chairman of the board, American Liver Foundation.

Alan Franciscus, executive director, Hepatitis C Support Project and editor-in-chief of HCV Advocate, San Francisco.

Thelma King Thiel, chair and CEO, Hepatitis Foundation International.

David Thomas, MD, professor of medicine, Johns Hopkins School of Medicine, Baltimore.

Howard J. Worman, MD, associate professor of medicine and anatomy and cell biology, College of Physicians and Surgeons, Columbia University, New York City.

The American Gastroenterological Association.

CDC: “Hepatitis C Questions and Answers for the Public.”

The Hepatitis Foundation International.

The HCV Advocate.

The National Institute of Allergic and Infectious Diseases.

CATIE: “How Hep C transmission happens.”

Mayo Clinic: “How common is sexual transmission of hepatitis C?”

American Red Cross: “Medications and Vaccinations.”

NEJM Journal Watch: “Hepatitis C Positive Organ Donors -- Coming Soon to a Transplant Center Near You.”

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