Though this liver-damaging virus doesn't spread easily, the consequences of catching it can be severe.

By Cindy Kuzma
Updated March 05, 2019

Some viruses can spread quickly, through a handshake, sneeze, or doorknob. But hepatitis C—a virus that causes inflammation of the liver—is different.

“Hepatitis C is a blood-borne pathogen,” says Sharon Nachman, MD, division chief of pediatric infectious diseases at Stony Brook Medicine. “That means any way that we transmit blood, we could get it.”

It's estimated that more than 3 million Americans have hepatitis C—but because it doesn’t always cause symptoms, many don’t know it. Up to 85% of short-term infections will become chronic, meaning you can have the virus for the rest of your life.

Understanding the risk factors and causes of hepatitis C is important, because seeking and getting treatment can prevent serious complications like scarring, liver failure, and even liver cancer. And fortunately, “‘once infected, always infected’ is a myth, as hepatitis C is treatable,” says Sudha Kodali, MD, hepatologist at Houston Methodist Hospital.

Here’s what you need to know about how the hepatitis C virus spreads so you can stop it—or seek screening and treatment if you’re at risk.

RELATED: 12 Hepatitis C Symptoms Everyone Should Know About

Is hepatitis C contagious?

Yes, but not in the same way as a cold or the flu. “Hepatitis C cannot be spread with casual contact,” says Samuel Sigal, MD, director of clinical hepatology at the Montefiore Einstein Center for Transplantation in New York City.

This means you can’t catch the virus from:

  • Using public toilets
  • Sneezing or coughing, or being around someone who is
  • Touching, holding hands, hugging, or kissing
  • Swimming in a public pool
  • Insect bites
  • Sharing utensils
  • Food and water
  • Breastfeeding

RELATED: 5 Surprising Facts About Your Liver

How is hepatitis C transmitted?

The way the virus does spread is through contact with the blood of someone who is infected. Most commonly, this occurs through one of the following methods.

Intravenous drug use
People who share needles or other supplies while injecting drugs like cocaine and heroin have a high risk for contracting hepatitis C. Even if you only used these types of drugs once years ago, there is still a chance you are infected.

Needlestick injuries
Health care or other safety workers may come into contact with an infected person’s blood if they’re accidentally stuck with a contaminated needle or other sharp object. Parents often worry about their children developing hepatitis C after finding a needle on the ground or at the beach. While that’s possible, it’s unlikely, Dr. Nachman says—the most commonly discarded needles are insulin needles, which typically don’t contain enough blood to transmit hepatitis C. Plus, the virus can only survive about a day outside of the body.

Medical procedures
Now, donated blood and organs are screened for the hepatitis C virus. However, before 1992, that wasn’t the case, so people who received blood transfusions or an organ transplant before that time might have become infected.

Sexual contact
If you have unprotected sex with an infected person, you can also develop the infection. That said, the rate of sexual transmission of hepatitis C isn’t high, Dr. Sigal says: “It is very unusual.” The risk increases if you have multiple sexual partners or another sexually transmitted infection, such as HIV.

Tattoos and piercings
These days, licensed and regulated tattoo parlors don’t pose much of a danger. However, piercings or tattoos received in unregulated settings, such as prisons, may spread hepatitis C, Dr. Kodali says.

Mother to child
Women who are infected with hepatitis C can pass it along to their children during birth, but this isn’t common—it only occurs up to 6% of the time. Mothers who were infected during pregnancy—rather than beforehand—may have a higher risk of passing the virus along, Dr. Nachman says. Having more than one infection, such as HIV or chlamydia along with hepatitis C, may also increase the odds, she adds.

RELATED: 8 Things You Probably Didn’t Know About Hepatitis

How can you prevent the spread of hepatitis C?

Now that you know how you get hepatitis C, you can take steps to protect yourself from the virus. For instance:

  • Avoid sharing needles or other paraphernalia related to intravenous drugs.
  • Wear gloves if you’re a health care worker or otherwise exposed to needles or potentially infected blood.
  • Use barrier methods—aka condoms—outside of sexually monogamous relationships.
  • Don’t share toothbrushes or other dental equipment, nail clippers, or shaving tools.
  • If you’re getting a tattoo or piercing, make sure the artist or piercer uses sterile ink and needles.

If you have the hepatitis C virus, you can prevent passing it along to others by following those same steps, in addition to:

  • Covering any open sores or wounds.
  • Telling all your health and dental care providers you have the virus.
  • Avoiding donating blood.
  • Discussing your hepatitis C status before donating organs, other tissues, or semen.
  • Using condoms during sex.

The CDC recommends anyone born between 1945 and 1965 be screened for hepatitis C once. If you have other risk factors—such as ongoing injection drug use, HIV or AIDS, or are a health care worker exposed through a needlestick—your doctor might recommend more frequent testing.

The good news? New treatment advances have dramatically increased the percentage of people able to clear the virus from their bodies. So if you have hepatitis C, “we can treat you, we can cure you,” Dr. Nachman says, “and that’s an amazing thing.”

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