Hepatitis C (HCV) is a viral infection that primarily targets the liver, leading to inflammation and potentially severe liver damage over time. While acute HCV infection often presents with mild or no symptoms, it can progress to a chronic condition if left untreated. This long-term infection can result in serious complications such as cirrhosis, liver failure, and even liver cancer. Understanding how this virus spreads is key to preventing its transmission and protecting liver health.
How Hepatitis C Spreads Through Blood
Hepatitis C is most commonly transmitted through direct contact with infected blood. The sharing of needles or other drug injection equipment represents the most frequent route for new HCV infections, including syringes, needles, cookers, cotton, filters, and water used in drug preparation. HCV can survive in blood outside the body for several days or even weeks, increasing the risk associated with contaminated equipment.
Historically, blood transfusions and organ transplants before widespread screening, particularly before 1992, were significant sources of HCV transmission. Today, the risk from screened blood products is extremely low. However, unsafe medical procedures or practices, such as the reuse of unsterilized medical equipment, continue to pose a risk in certain settings globally. This also extends to procedures like tattooing or body piercing performed with non-sterile instruments in unregulated environments.
Occupational exposure also presents a transmission pathway, primarily for healthcare workers. Accidental needle stick injuries or other sharps injuries, where a healthcare professional is exposed to infected blood, can lead to HCV transmission. Although the risk from a single needle stick is relatively low, it remains a recognized hazard.
Other Ways Hepatitis C Can Spread
Beyond direct blood-to-blood contact, hepatitis C can also spread through less common routes. Sexual transmission is possible, though it is less efficient than blood-to-blood contact and carries a low risk. The risk of sexual transmission increases with factors such as multiple partners, other sexually transmitted infections, or sexual practices that involve potential blood exposure, like anal sex or rough vaginal sex that may cause tears or bleeding.
Another potential route is mother-to-child transmission, which can occur when an infected mother passes the virus to her baby during birth. This perinatal transmission happens in approximately 3% to 10% of cases when the mother has an active HCV infection. The likelihood of transmission can be higher if the mother also has HIV or a high viral load.
Sharing personal items that may have come into contact with blood, such as razors, toothbrushes, or nail clippers, can also pose a rare risk of transmission. The risk from these personal items is very low, but it is important not to share items that could be contaminated with blood.
How Hepatitis C Does Not Spread
Hepatitis C is not spread through casual contact. Activities like hugging, kissing, or shaking hands do not transmit the virus. Sharing food or drinks, eating utensils, or using public restrooms also poses no risk of HCV transmission.
The virus is not transmitted through sneezing or coughing. Mosquitoes or other insects, as well as animals, do not transmit hepatitis C.
Breastfeeding is safe for mothers with hepatitis C, as the virus does not spread through breast milk. Studies show that breastfed infants do not have higher rates of hepatitis C than formula-fed babies. However, if the mother has cracked or bleeding nipples, it is recommended to temporarily stop breastfeeding until the nipples heal to avoid potential blood-to-blood contact.