Hepatitis C is an infection caused by the hepatitis C virus (HCV). It can lead to serious liver damage, so it’s important to know all the ways it can be transmitted.

This can be tricky: Many people with hepatitis C can’t identify the source of their infection.

Keep reading to find out all the ways that hepatitis C can be transmitted, what increases your risk, and why testing is so important.

People contract hepatitis C by coming into contact with the blood of someone who has the virus. This can happen in several different ways.

Sharing drug equipment

One of the most common ways HCV is spread is through reusing drug equipment. People who inject drugs may reuse needles or equipment that’s used to prepare drugs.

This can expose them to the bodily fluids of others, including those with HCV.

Since drug use can affect judgment, people may continue to repeat behaviors like needle sharing.

According to the National Institute on Drug Abuse, one person with HCV who injects drugs can potentially go on to transmit the virus to 20 other people.

Poor infection control for tattooing and piercing

The Centers for Disease Control and Prevention (CDC) notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.

Commercially licensed tattooing and piercing businesses are generally thought to be safe.

More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a significant risk of HCV transmission

Blood transfusions

Prior to 1992, receiving a blood transfusion or organ transplant was a significant risk factor for contracting HCV. However, this route of transmission is now considered very rare.

According to the CDC, the risk of infection is less than one case per every 2 million units of blood transfused.

Nonsterile medical equipment

In rare cases, HCV can be spread through nonsterile medical equipment. This can occur due to things such as:

  • reusing a needle or syringe that someone with hepatitis C has already used
  • mishandling of multidose drug vials or intravenous drugs such that they become contaminated with the blood of someone with hepatitis C
  • poor sanitation of medical equipment

Consistently using appropriate infection control measures can limit this type of transmission. From 2008 to 2019, there were only 66 healthcare-associated outbreaks of hepatitis C and hepatitis B.

Sharing hygiene supplies

Another way that hepatitis C gets transmitted is through the sharing of personal hygiene products that have come into contact with the blood of someone with HCV.

Some examples include things like razors, toothbrushes, and nail clippers.

Unprotected sex

According to the CDC, hepatitis C can also be transmitted through sexual contact, though the risk is low.

Certain sexual behaviors have a higher risk than others when it comes to increasing your chances of contracting the virus.

Pregnancy and childbirth

Hepatitis C can be passed to a baby during childbirth, but this only occurs in about 6 percent of cases.

If your mother had hepatitis C when you were born, you may have a slightly higher risk of getting the virus.

Needle sticks

It’s also possible to get hepatitis C through an accidental injury, such as getting stuck with a needle that has come into contact with blood that contains HCV. This type of exposure often occurs in a healthcare setting.

However, the risk of contracting hepatitis C due to something like a needle stick is still rather low. It’s estimated that only about 1.8 percent of occupational exposures to HCV lead to an infection, although this number may be even lower.

How hepatitis C isn’t spread

The CDC confirms that you can’t contract hepatitis C through:

  • eating with utensils shared by someone with hepatitis C
  • holding hands, hugging, or kissing someone with hepatitis C
  • being near someone with hepatitis C when they cough or sneeze
  • breastfeeding (babies can’t get hepatitis C through breast milk)
  • food and water

Sexual contact is considered to be an inefficient mode of transmission for HCV. However, some sexual behaviors can increase a person’s risk of contracting hepatitis C.

These include:

  • having sex without condoms with more than one sexual partner
  • having a sexually transmitted infection or HIV
  • engaging in sexual activity that could cause bleeding

Some research suggests that men who have sex with men may be at an increased risk of contracting HCV through sex. This risk increases if an individual also has HIV.

The National Institutes of Health advises using condoms during sex to help prevent the spread of infection. Also, don’t hesitate to talk with your doctor if you have questions or concerns about your risk factors.

Some factors can increase your risk of contracting hepatitis C. These include:

  • current or past use of injection drugs
  • HIV
  • exposure to HCV virus through an injury such as a needle stick
  • being born to a mother that has HCV
  • getting a tattoo or piercing using nonsterile equipment
  • receiving a blood transfusion or organ transplant prior to 1992
  • receiving clotting factors prior to 1987
  • being on kidney dialysis (hemodialysis)
  • living or working in a prison

Some people that have HCV will clear their infection. However, in 75 to 85 percent of people, the infection will become chronic.

Medications are now available to help clear HCV from your body. According to the CDC, 90 percent of people receiving current treatments will clear their infection.

Because your body doesn’t generate a strong immune response to HCV, it’s possible to contract the virus again. While the rate of reinfection is low, the risk may be increased in people who:

  • inject drugs
  • have HIV
  • engage in sexual activities that may lead to bleeding

People with hepatitis C can’t currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.

According to the Department of Health and Human Services (HHS), information on organ donation, those with underlying medical conditions shouldn’t rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.

People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.

A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.

Because of this, it’s important to be tested if you believe you’ve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.

Testing recommendations

The CDC currently recommends that all adults aged 18 and older be tested at least once during their lifetime. Additionally, it’s recommended that pregnant women be tested for HCV during each pregnancy.

One-time HCV testing is recommended for people who:

  • have HIV
  • were born to a mother with HCV
  • previously injected drugs
  • previously received kidney dialysis
  • received a blood transfusion or organ transplant prior to 1992 or clotting factors prior to 1987
  • were exposed to HCV-positive blood through an accident such as a needle stick

Some groups should receive more routine testing. These groups include people who are currently using injected drugs and those currently receiving kidney dialysis.

HCV can be spread through contact with the blood of someone who has the virus. This most commonly happens by reusing drug equipment.

However, it can also occur via needle sticks, sharing hygiene items, and nonsterile tattooing or piercing practices. Sexual transmission is rare.

Knowing the risk factors for contracting HCV will help prevent transmission of the virus. If you believe that you may have hepatitis C, talk with your doctor about testing and seek early treatment. This can help reduce your chance of liver damage.