Hepatitis C (HCV) is a viral infection that primarily targets the liver, causing inflammation that can lead to significant liver damage over time. This infection can manifest as an acute illness, which is short-term, or progress to a chronic, lifelong condition. Globally, an estimated 50 million people live with chronic HCV infection, underscoring its widespread impact on public health. The virus spreads primarily through blood-to-blood contact.
Primary Modes of Transmission
The most common way Hepatitis C is transmitted is through sharing equipment used for injecting drugs. This includes not only needles and syringes but also other items like “cookers,” cotton, and water. Even microscopic amounts of blood, invisible to the naked eye, can carry the virus if shared equipment is contaminated. Injection drug use is the leading cause of new HCV infections.
Unsterilized medical procedures also pose a transmission risk, particularly in settings outside regulated healthcare environments. This occurs when medical or dental instruments, especially needles and syringes, are reused or improperly sterilized between patients. Such practices can directly introduce infected blood into another person’s bloodstream. Healthcare workers also face occupational exposure through needle stick injuries.
Other Potential Exposure Pathways
Historically, blood transfusions and organ transplants before 1992 were significant sources of HCV transmission. Routine screening of blood products for HCV began in 1992, making transmission via these routes extremely rare today. However, individuals who received transfusions or transplants before this time remain at risk.
Perinatal transmission, where a mother with HCV passes the virus to her baby during birth, is another pathway. This risk is relatively low, occurring in approximately 5-7% of pregnancies when the mother has an active infection. Sexual transmission of HCV is generally low, especially in long-term monogamous relationships. The risk increases with multiple partners, the presence of other sexually transmitted infections, or sexual practices that involve blood exposure.
Unregulated tattooing or piercing practices, particularly those using unsterilized instruments, can also transmit HCV. This risk is distinct from licensed, professional establishments that adhere to strict sterilization guidelines. Sharing personal care items that might have come into contact with blood, such as razors, toothbrushes, or nail clippers, is a very rare, but possible, route of transmission.
Considering Testing Based on Risk
Understanding these risk factors is important for knowing when to consider HCV testing. The Centers for Disease Control and Prevention (CDC) recommends universal one-time screening for all adults aged 18 and older. This recommendation also extends to all pregnant women during each pregnancy.
Beyond universal screening, targeted testing is advised for specific high-risk groups. These include individuals who have ever injected drugs and people living with HIV. Individuals who received blood transfusions or organ transplants before 1992 should also be tested. Those born to a mother with HCV, healthcare workers with needle stick exposures, and anyone with signs of liver disease are also recommended for testing. Early diagnosis allows access to effective treatments that can cure the infection and prevent serious liver damage.