Protecting Yourself and Others from Hepatitis C

HOW IS HEPATITIS C TRANSMITTED?

Hepatitis C is a bloodborne virus, and is transmitted through direct blood-to-blood contact. The most common ways for hepatitis C to be transmitted is through sharing needles or injection equipment with an infected person, having had a blood transfusion prior to 1992, sharing personal care items such as razors that could have infected blood on them, and from mother to child during childbirth. In rare cases, hepatitis C can be transmitted through sex.

HOW EASY IS IT TO GET HEPATITIS C THROUGH SEX?

It is possible to transmit hepatitis C through sex, but it is not an efficient transmission method. It is much more likely to get hepatitis C through sharing needles or “works,” or having had a blood transfusion before 1992. According to the Hepatitis C Support Project, if someone is in a long-term relationship with a person who has hepatitis C, there is only a small chance (up to 3% over 20 years) that they could get hepatitis C from their sexual partner. (This assumes that neither partner is having sex outside the relationship.) However, the chances of getting infected with hepatitis C through sexual activity is higher among people who have many sexual partners or are in so called high-risk groups (men who have sex with men, sex workers, people with sexually transmitted infections, and people who practice rough sex.

WHAT IS THE RISK OF TRANSMISSION OF HEPATITIS C FROM MOTHER TO CHILD?

The risk of hepatitis C transmission from mother to child averages 5% (about a 1 in 20 chance) or less. There is no known way to reduce the risk.

IF PEOPLE GET HEPATITIS C WILL THEY ALWAYS HAVE IT?

Not necessarily. About 15% to 25% of the people who get infected with hepatitis C clear the virus completely out of their bodies naturally. This means that those people are no longer infected and can no longer spread the virus to other people.

However, the remaining 75% to 85% of people infected with hepatitis C become chronically infected. These people have the potential to transmit the virus to others through blood. Nobody knows why some people clear the virus and some people don’t. There is no way to know in advance who would naturally clear it and who would not. However, a test can be done to determine whether or not a person still has hepatitis C.

Fortunately, a growing number of antiviral medications are now available and under development to treat chronic hepatitis C infection. When used in combination, these medications have the potential to cure chronic hepatitis C in a large proportion of those infected. For more information about hepatitis C treatment, please see the “How Is Chronic HCV Infection Treated?” section on The Basics of Hepatitis C page.

CAN PEOPLE BECOME REINFECTED WITH HEPATITIS C?

Yes. People who have cleared the virus either naturally or through medication can become infected again. Also, people who have active hepatitis C can become infected with additional genotypes (strains) of hepatitis C.

IF PEOPLE HAVE HEPATITIS C, WILL THEY GET SICK OR DIE FROM IT?

Some people who are infected with hepatitis C do get very sick and may die as a result of liver disease or other health conditions that are worsened by chronic hepatitis C infection. The number of HCV-related deaths in the U.S. has been rising in recent years and now exceeds the deaths from HIV and AIDS.

Interestingly, the relatively small proportion of people who develop acute illness symptoms as a result of hepatitis C infection tend to recover from their illness and have no lasting liver damage. About 60% to 70% of persons who are chronically infected with hepatitis C develop chronic liver disease. About 5% to 20% develop cirrhosis over a period of 20 to 30 years after being infected, and about 1% to 5% ultimately die from cirrhosis or liver cancer. Most people with hepatitis C will live for more than 20 years without having any serious symptoms. However, people who are coinfected with HIV may progress to liver disease more quickly.

Fortunately, the development of new hepatitis C treatments that are highly effective in curing chronic hepatitis C – even in persons coinfected with HIV – has the potential to substantially reduce the rates of HCV-related deaths and illnesses in the years ahead. For more information about hepatitis C treatment, see The Basics of Hepatitis C web page.

ARE THERE THINGS THAT CAN MAKE HEPATITIS WORSE OR MAKE THE SYMPTOMS APPEAR FASTER?

Yes. If someone has hepatitis C, there are several things that can increase the likelihood that the virus will cause liver damage.

Drinking alcohol (any amount) is very dangerous to a person who has hepatitis C since alcohol also causes liver damage.

In HIV and hepatitis C coinfected people, the risk of developing liver damage is much higher than in those people who only have hepatitis C. When people are coinfected with HIV and hepatitis C, they tend to get sick from hepatitis C sooner than if they only had hepatitis C.

Some medications are hard on the liver and generally should not be taken when people have hepatitis C. However, sometimes an urgent medical need for a particular medication overrides the possibility of liver damage. This is something for people to talk about with their doctors.

WHAT ARE SOME THINGS THAT SOMEONE WITH HEPATITIS C SHOULD AVOID?

Avoiding alcohol (even small amounts) is very important. Tylenol and other over-the-counter and prescription drugs can sometimes cause liver damage. High iron diets may also cause problems. Good nutrition, regular exercise, and adequate sleep are helpful in keeping the liver healthy. We recommend speaking with your doctor or hepatitis specialist about all the medications and supplements you are taking to see whether they are safe for the liver.

If you have specific questions about hepatitis C prevention or other hepatitis C-related health issues, please contact AIDS Action’s Health Library at 617.450.1432 or visit the Health Library page.