Hepatitis C is a contagious, bloodborne virus that causes liver inflammation. If not treated quickly, a hepatitis C infection can cause permanent liver damage and lead to life threatening complications.

In the United States, injecting drugs is the most common way people contract the hepatitis C virus (HCV). Rates of hepatitis C are rising in the United States alongside the use of injectable drugs, such as heroin.

People who use drugs intravenously (IV) often have a higher risk of hepatitis C than people who do not inject drugs. Let’s take a closer look at what experts know about this connection.

HCV is bloodborne. It’s transmitted when the blood of a person with an HCV infection enters the body of a person who doesn’t have HCV. In the United States, hepatitis C is the most common chronic virus that is transmitted through blood contact.

Some bloodborne viruses can be sexually transmitted. Hepatitis C is typically only transmitted sexually through condomless anal sex or through sex with a person who is menstruating — situations when blood is likely to be present.

However, even in these cases, the sexual transmission of hepatitis C is rare.

Most of the time, hepatitis C is transmitted through the sharing of needles and other IV drug use equipment.

When you inject drugs using a needle that someone else used first, some of their blood can be left on or in the needle, even if it’s not visible to you.

If the person who used the needle before you has an HCV infection, you can contract the infection too.

People who have hepatitis C often don’t know they have the infection for weeks, months, or even years. This contributes to the transmission of the virus because it makes it more likely to share drug equipment with a person who has hepatitis C and doesn’t know it.

The National Institute on Drug Abuse reports that every person who has hepatitis C and uses injectable drugs will transmit the infection to 21 other people.

Other risks of IV drug use

Hepatitis C isn’t the only virus that may occur during IV drug use. HIV can also be transmitted this way.

The CDC states IV drug use is the second most common way HIV is transmitted, after anal sex without a barrier method, like a condom.

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HCV starts as an acute infection and can develop into a chronic condition.

Many people who have acute hepatitis C never develop any symptoms at all. If you do develop symptoms, they will most likely show up within 2 to 12 weeks of contracting the virus.

Symptoms of acute hepatitis C can include:

If the acute infection isn’t cleared from your body, it can develop into chronic hepatitis C. More than half of people who get hepatitis C will develop a chronic infection.

Chronic hepatitis C symptoms can include:

  • weight loss
  • difficulty concentrating
  • persistent fatigue
  • depression or anxiety
  • joint pain and muscle aches
  • rashes
  • kidney problems

Doctors use two main blood tests to check for hepatitis C:

It’s possible to cure hepatitis C. Treatments for hepatitis have made incredible advances over the past decade.

A doctor can prescribe direct-acting antiviral (DAA) oral medication tablets if you have acute hepatitis C. If you take these medications within 8 to 12 weeks of contracting the infection, your chances of completely clearing the virus are close to 100 percent.

Antivirals work to stop a virus from multiplying, so your immune system can catch up and eliminate it.

If you have chronic hepatitis C, a doctor may first prescribe the injectable therapy peginterferon alfa with the oral medication ribavirin.

Some people who have had hepatitis C for several years may already have liver scarring. Beta-blockers and nitrates can be prescribed to support liver function.

Lifestyle changes, such as stopping alcohol consumption, may be recommended as well.

Treating hep C and substance use disorder

Treatments for people who have hepatitis C and use intravenous drugs work best when combined with individualized, compassionate support.

Reinfections with hepatitis C are possible, which makes it more challenging to treat and prevent HCV infection if you are currently using IV drugs.

If you are getting treatment for a substance use disorder, such as taking medication-assisted treatment like methadone, there are some medications you need to avoid.

But DAA tablets to treat hepatitis C are approved even if you are taking medication-assisted treatments like methadone or buprenorphine.

There’s currently no vaccine available to prevent hepatitis C. Avoiding contact with blood and bodily fluids is the best way to avoid being exposed to the virus.

Steps you can take to reduce your risks of contracting or transmitting hepatitis C include:

  • not engaging in, or stopping, IV drug use
  • if using IV drugs, never sharing needles or drug equipment
  • using safe syringe services programs if they are available in your community
  • getting frequently tested for hepatitis C if you do use IV drugs

Hepatitis vaccines

While there is no vaccine for hepatitis C, there are safe and effective vaccines for hepatitis A and B. Learn more below:

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If you have a substance use disorder (SUD), treatment and support is available. Treating SUD involves addressing both the physical and mental health effects of addiction, and helping you develop a strategy for long-term recovery.

Individual therapy and support groups, such as Narcotics Anonymous, can help support you in stopping IV drug use. Inpatient and outpatient treatment programs created specifically to treat SUD can also be a part of your treatment plan.

Medication can help reduce your body’s chemical reaction to IV drugs. Methadone or buprenorphine may be prescribed during the initial withdrawal stage to help you cope as you stop using IV drugs. For some people, these medications may be advised more long term.

Visit the Substance Abuse and Mental Health Administration (SAMHSA) treatment portal to find a support group, rehab facility, or counselor near you, as well as recommendations for hotlines and online resources.

People who use IV drugs have a higher risk of hepatitis C infection because the virus is transmitted through blood contact.

Unlike hepatitis B, there’s currently no vaccine that offers protection from hepatitis C. Direct-action antiviral medication can help your body quickly clear the infection so it does not develop into a chronic condition.

However, hepatitis C is often asymptomatic, so frequent testing is typically the only way to diagnose hepatitis C before it causes damage to your liver.

Know your risk of hepatitis C, and remember that there is no safe way to share needles or drug supplies. If available in your area, safe syringe service programs can provide clean supplies to you to lower risk of contracting hepatitis C or other viruses, like HIV.

The best approach to avoiding hepatitis C is to stop using IV drugs. If you are living with a substance use disorder, know you are not alone, and help is available.