Hepatitis C risk factors: how it spreads and who is at risk

What hepatitis C is

Hepatitis C is a viral infection that causes inflammation and damage in the liver (NIDDK). It can be acute, a short-term infection that goes away, or chronic, a long-lasting infection where the virus stays in the body (NIDDK). NIDDK says more than half of people with acute hepatitis C go on to develop chronic hepatitis C, and MedlinePlus says this happens for most people (NIDDK) (MedlinePlus).

Researchers estimate that less than 1% of people in the United States are infected, and that chronic hepatitis C still affects more than 2 million people in the US (NIDDK). In countries where it is most common, in parts of Eastern Europe, Africa, the Middle East and Asia, an estimated 2% to 6% of people are infected (NIDDK).

How the virus spreads

The hepatitis C virus spreads through contact with an infected person's blood (NIDDK). NIDDK and MedlinePlus list these ways (NIDDK) (MedlinePlus):

• sharing needles or other equipment used to inject drugs
• an accidental stick with a needle used on an infected person, which can happen in health care settings
• tattoos or piercings done with tools or ink that were not sterile
• contact with an infected person's blood or open sores
• using an infected person's razor, toothbrush or nail clippers
• being born to a mother who has hepatitis C
• unprotected sex with an infected person
• dental or medical procedures with needles or tools that were not properly cleaned, in countries where hepatitis C is common

In the United States, injecting drugs is the most common way people get hepatitis C (NIDDK) (MedlinePlus). Before 1992 it also commonly spread through blood transfusions and organ transplants; the US blood supply has been tested for the virus since then, and getting it this way is now very rare (MedlinePlus).

You cannot get hepatitis C from coughs or sneezes, food or water, hugging, shaking or holding hands, sitting next to someone, or sharing forks, spoons and other eating utensils (NIDDK). A baby cannot get it from breast milk, though NIDDK advises avoiding breastfeeding if the nipples are cracked or bleeding (NIDDK).

Who is more likely to get hepatitis C

Combining the NIDDK and MedlinePlus lists, hepatitis C is more common in people who (NIDDK) (MedlinePlus):

• inject drugs or have injected drugs in the past
• have HIV
• have been on kidney dialysis
• received donated blood, blood products or an organ before 1992 (MedlinePlus says before July 1992)
• have hemophilia and received clotting factor before 1987
• have been in contact with blood, needles or syringes at work
• were born to a mother with hepatitis C
• were born in a country where hepatitis C is common (NIDDK list)
• have had tattoos or body piercings (MedlinePlus list)
• have worked or lived in a prison (MedlinePlus list)
• have had more than one sex partner in the last 6 months, have had a sexually transmitted infection, or are a man who has had sex with men (MedlinePlus list)

Spread through sex is possible but the chances are low (NIDDK). NIDDK names higher risk groups: men who have sex with men, and people who have multiple sex partners, have HIV or other sexually transmitted diseases, or engage in rough sex (NIDDK).

Having had hepatitis C before does not protect you: you can get it again (NIDDK).

Why chronic hepatitis C matters

Most people with hepatitis C have few or no symptoms (NIDDK) (MedlinePlus). People with chronic hepatitis C may have no symptoms until complications such as cirrhosis develop, which can be decades after infection (NIDDK). Without treatment, chronic hepatitis C can lead to cirrhosis, liver failure and liver cancer (NIDDK). See cirrhosis risk factors and liver cancer risk factors.

Because so many people have no symptoms, testing matters. NIDDK says doctors typically recommend screening at least once for all adults, during each pregnancy, for people at risk, and for anyone who asks (NIDDK). The hepatitis C screening check covers who is advised to get tested.

How to lower your risk

There is no vaccine for hepatitis C (NIDDK) (MedlinePlus). You can help protect yourself by (NIDDK) (MedlinePlus):

• not sharing needles or other drug equipment
• wearing gloves if you have to touch another person's blood or open sores
• making sure a tattoo artist or piercer uses sterile tools and unopened ink
• not sharing toothbrushes, razors or nail clippers
• using a latex or polyurethane condom during sex

If you think you may have been exposed to the virus, see your doctor as soon as possible: early diagnosis and treatment can help prevent liver damage (NIDDK).

Common questions

Is hepatitis C curable?

Yes, in most cases. Antiviral medicines can cure more than 95% of people with chronic hepatitis C in 8 to 12 weeks, though some people need longer treatment (NIDDK).

How is hepatitis C different from hepatitis B?

Both viruses infect the liver and can spread through blood. Hepatitis C has no vaccine, while hepatitis B does (NIDDK). NIDDK suggests that people with hepatitis C talk with their doctor about vaccines for hepatitis A and hepatitis B, which could further damage the liver (NIDDK). See the hepatitis B risk factors guide.

Which risk factors can I change?

Past blood transfusions, being born to a mother with hepatitis C and where you were born cannot be changed. Not sharing needles or personal items like razors, choosing sterile tattoo and piercing tools, and using condoms are steps on the NIDDK and MedlinePlus lists (NIDDK) (MedlinePlus). If you have hepatitis C, NIDDK advises avoiding alcohol because it can cause more liver damage (NIDDK).