Causes and Risk Factors of Hepatitis C

Hepatitis is inflammation of the liver. There are several causes of liver inflammation, one of them being the hepatitis C virus (HCV). 

Hepatitis C is an infectious disease that is caused by the hepatitis C virus and affects the liver. About 185 million people worldwide are living with hepatitis C. The condition can cause symptoms like nausea, general discomfort (malaise), abdominal pain, and more. But some people with hepatitis C may not experience any noticeable symptoms. Hepatitis C can last for six months (acute hepatitis C) or longer (chronic hepatitis C). If left untreated, long-term hepatitis C can lead to worse liver complications.

Hepatitis C is spread by coming in contact with blood from a person with HCV. Some people may be at greater risk of getting HCV.

Man holding right side of stomach (near liver) in pain

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Risk Factors for Hepatitis C

Coming into contact with blood from a person with HCV can happen in a variety of ways. The most common ways HCV is contracted is through shared needles for drug use, but it can also occur in other ways.

Sometimes the cause for contracting the hepatitis C virus is never found.

Shared Needles and Other Drug Paraphernalia

Sharing or reusing needles from other people for drug injections can increase your risk of contracting the hepatitis C virus. Sharing straws used for snorting cocaine or other drugs can also transmit HCV through contaminated blood.

The hepatitis C virus has been found to remain active within needle syringes for up to nine weeks after contamination.

Needle Exchange Programs

Needle exchange programs (NEP) are free harm reduction programs that accept and properly dispose of used needles as well as provide new, clean needles. This helps reduce the spread of bloodborne diseases such as HCV and HIV. You can find a list of these programs using the NASEN directory.

Personal Hygiene Tools

Sharing personal hygiene tools such as razors or toothbrushes could put you at risk of contacting other people’s blood.  This, in turn, can increase your chances of getting hepatitis C. It is safest to not share these items and other self-care items that may come into contact with blood.

Tattoos and Piercings

Hepatitis C can spread in facilities that fail to sterilize their instruments. Unregulated tattooing and piercing that occur in prisons and other informal settings may put a person at risk getting HCV.

All needle supplies must be sterilized before use. If a needle doesn’t come in a pre-sealed package opened in front of you, don’t hesitate to ask for a sterilized package of supplies.

Birthing Parent to Infant Transmission

About 6% percent of babies who are born to people who carry the hepatitis C virus at the time of birth can get hepatitis C. The risk of HCV infection in the infant goes up twofold when the parent giving birth has both HCV and human immunodeficiency virus (HIV).

According to the CDC, breastfeeding won’t transmit the virus to your baby. However, people with cracked or bleeding nipples should stop breastfeeding temporarily until they have healed.

Sexual Behaviors

Though it’s not common, HCV can spread through sexual transmission. Particularly, people having unprotected receptive anal sex with more than one partner are at high risk.

Using condoms may help lower the risk of becoming infected with the virus. However, condoms alone are not sufficient enough to prevent the spread of hepatitis C in stable monogamous (one partner only, long-term) sexual partnerships.

As some people with HCV may not experience any symptoms, it’s important that you and your partner get tested for HCV.

Getting Tested for Hepatitis C Virus

In general, the CDC recommends HCV screening for all adults at least once in their life and for pregnant people with every pregnancy, unless your healthcare provider determines your chance of getting it is less than 0.1% (1 in 1000).

Blood Transfusions and Organ Transplants

Prior to 1992, blood transfusions and organ transplants accounted for about 10% of exposures to hepatitis C, but due to donor screening involving new technology, the risk has decreased to less than one in a million.

If you received a blood transfusion prior to 1992, talk with your doctor about blood tests to screen for hepatitis C virus.


Hemodialysis is a common treatment for kidney dysfunction. It pumps blood out of the body to an artificial kidney machine to filter out bodily waste products and excess water and then returns the blood to the body.

The longer you've been receiving hemodialysis, the higher your risk of contracting HCV. This is because of the very small chance that the hemodialysis machine is contaminated with HCV-positive blood.

In hospitals, people receiving hemodialysis are at higher risk than those receiving peritoneal dialysis (a type of dialysis that uses the abdomen as a filter to remove toxin buildup).

Healthcare Exposures

HCV transmission can occur in labs or healthcare settings like hospitals or clinics when people are accidentally exposed to HCV-positive blood, whether through handling blood samples or medical equipment. In particular, healthcare workers may be at higher risk of needlestick injuries, which can occur with syringes and needles. The use of standard precautions by nurses, lab technicians, and doctors (such as wearing gloves) can help prevent exposure.

Following certain preventive measures like wearing an extra layer of gloves, using safety features to help contain the needle after use, and using clear communication when passing needles to others has been shown to decrease needlestick injuries by 53% in the operating room.

How Hepatitis C Cannot Be Transmitted

As long as no blood is involved, you cannot get HCV from:

  • Kissing or hugging
  • Sneezing or coughing
  • Casual skin contact
  • Sharing food, water, eating utensils, or drinking glasses
  • Swimming in a pool
  • Using public toilets
  • Shaking hands

Is Hepatitis C Hereditary?

Hepatitis C is not hereditary, meaning it is not a genetic condition that is passed down from generation to generation within families. However, there is a low chance that a birthing parent with HCV can pass on the virus to their baby when giving birth.

A family living together could potentially contract the virus through a break in the skin involving blood of an infected family member, although the risk is low.

Who Gets Hepatitis C?

Anyone can get hepatitis C if they come in contact with HCV-positive blood. Some people may be more likely to get hepatitis C than others, especially those with any risk factors for HCV transmission.

Rates of hepatitis C can vary by different demographics and location.


Worldwide, hepatitis C can vary by geography. According to the World Health Organization, the area with the highest rate is the Eastern Mediterranean and European regions with 12 million people who have the virus. The second highest are the South-East Asian and Western Pacific regions with 10 million HCV-positive people. The lowest regions are the Americas at 5 million people.  


Newly reported cases of chronic hepatitis C tend to be greater in people assigned male at birth, compared to those assigned female.


Unless a child comes in contact with the virus at birth, children are at lowest risk of contracting the virus.

New onset HCV tends to be most common in adults aged 20–39. This is likely because this age group may be when people start using injectable drugs. Notably, positive cases of hepatitis C have increased substantially among young adults over the past decade.

In some people, hepatitis C can go undetected for years, especially if they don’t show any symptoms until a chronic condition results in liver complications. This can lead to detecting the virus at a later age. In the U.S., new HCV cases in people aged 55–70 is the second most common age group.


In the United States, hepatitis C rates are most common in Indigenous Americans—with  2.1 cases per 100,000 population as of 2020. Asian Americans and Pacific Islanders have the lowest incidence at 0.4 cases per 100,000 population in the same year.

A Quick Review

Hepatitis C is caused by the hepatitis C virus (HCV), which can be transmitted from person to person through contact with HCV-positive blood. Several factors can put you at higher risk of getting HCV—with needle sharing during injectable drug use being the most common. Talk with your healthcare provider about getting screened for HCV. They can provide a diagnosis and any necessary treatments.

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