What Are the Risk Factors for Hepatitis C?

What’s the short answer?

Hepatitis C is primarily transmitted by sharing needles, syringes, or other equipment to prepare or inject drugs. It can also be transmitted through exposure to blood or other bodily fluids during sexual activity.

Acute hepatitis C occurs within the first 6 months after exposure. A hepatitis C infection that lasts longer than 6 months is considered chronic. If left untreated, hepatitis C can cause liver damage, cirrhosis, and liver cancer.

Who’s most at risk of developing hepatitis C?

Injection drug use is still the most common risk factor in both the United States and the United Kingdom.

People who used injection drugs and shared equipment long ago may still develop symptoms of chronic hepatitis C later in life, especially if the virus was never detected and treated.

Others at risk for hepatitis C infection include:

• healthcare workers who experience accidental needle pricks while caring for people with hepatitis C
• infants birthed by a parent with hepatitis C
• people who received transfusions, organ transplants, or other blood products before proper screening was introduced in June 1992

Hepatitis C is less commonly transmitted by:

• having condomless oral, vaginal, or anal sex with someone who has hepatitis C
• engaging in rough sex or sexual play involving blood or other bodily fluids with someone who has hepatitis C
• using shared equipment to prepare or ingest cocaine
• getting tattoos or piercings in unlicensed facilities or with nonsterile instruments
• sharing personal hygiene items that may come into contact with blood, like razors and toothbrushes

What are the earliest signs and symptoms of hepatitis C?

Many people who contract the hepatitis C virus are asymptomatic and unaware they’ve been exposed. According to the World Health Organization, approximately 4 out of every 5 people (80%) don’t experience any symptoms at first.

When symptoms do occur, they may include:

• fever
• fatigue
• decreased appetite
• nausea
• vomiting
• abdominal pain
• dark urine
• pale stool
• joint pain
• yellowing of the skin or eyes (jaundice)

It can take anywhere from 2 weeks to 6 months for a hepatitis C infection to develop after exposure to the virus.

In some cases, the body can clear the infection on its own before diagnosis or treatment occurs.

How is hepatitis C diagnosed?

Hepatitis C is diagnosed using an antibody test and a PCR test. Both blood tests offer slightly different insights into the state of infection.

Antibody test

An antibody test can determine whether you have ever been exposed to hepatitis C by looking for anti-HCV antibodies.

It may take a few months after the initial infection to build up a detectable level of antibodies.

If you’re experiencing symptoms of hepatitis C, but your antibody test result is negative, you may be encouraged to re-test at a later date.

If your test result is positive, you’ve contracted the hepatitis C virus at some point. A positive result doesn’t mean that you’re currently experiencing a hepatitis C infection, just that you have previously been exposed to the virus.

The only way to determine whether you have a current hepatitis C infection is through a PCR test.

PCR test

A PCR test can measure the overall viral load and determine whether the virus is actively reproducing in your body. The lower the viral load, the less likely you are to be experiencing a current hepatitis C infection.

Your clinician will use the results of your PCR test to create a treatment plan, if appropriate. The primary goal of treatment is to reduce the overall viral load to zero.

If your clinician suspects that your liver has been damaged, they may recommend additional tests or refer you to a specialist to discuss your next steps.

What can you do to reduce your risk of hepatitis C?

Although there’s a vaccine for hepatitis A and hepatitis B, there isn’t a vaccine for hepatitis C.

The best way to reduce your risk of contracting the hepatitis C virus or transmitting it to others is to practice harm reduction. This applies to substance use and partnered sexual activity.

If you use intravenous drugs or other substances, this means:

• using sterile syringes, needles, or straws whenever possible
• safe handling and disposal of syringes, needles, and other medical waste
• cleaning the area of injection before and after intravenous drug use

If you engage in partnered sexual activity, this means:

• regularly testing for hepatitis C and other STIs
• asking your partner(s) about their STI status and sharing yours
• using a condom or other barrier method consistently and correctly

The Centers for Disease Control and Prevention recommends that all adults should screen for hepatitis C at least once in their lifetime and that adults who are at an increased risk for hepatitis C screen more regularly.

If you’re unsure about your risk for hepatitis C, consult with a doctor or other healthcare professional. They can recommend a screening schedule that best suits your needs.

The bottom line

Hepatitis C is usually asymptomatic, so routine testing is key. Early diagnosis and treatment can help prevent chronic hepatitis C and its complications, including irreparable damage to the liver.

A proper diagnosis and care plan can also reduce the likelihood of transmission or reinfection.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.