Hepatitis C Prevention

• How Do You Get Infected With Hepatitis C?
• Can Household Contact Transmit Hepatitis C?
• Injection Drug Use
• What About Tattooing?
• Transmission From Mothers to Children
• Health Care Workers
• Can HCV Be Spread by Sexual Activity?
• What if I've Been Exposed?
• The Bottom Line

How Do You Get Infected With Hepatitis C?

The hepatitis C (HCV) virus spreads primarily through contact with infected blood. Even very small amounts of blood -- too small to be seen -- can transmit hepatitis C. In used syringes, blood can be infectious for three weeks. The virus can survive in dried blood spills for up to four days.

Before 1990, there was no way to test blood for HCV. Many people were infected by blood transfusions or blood products, such as those used by hemophiliacs. In the early 1990s, blood banks began to test for hepatitis C. Where this is done, new infections are not occurring. However, if blood is not tested, or if medical equipment is not sterilized, HCV infection can occur.

Can Household Contact Transmit Hepatitis C?

Normal household contact does not spread hepatitis C. It is not transmitted by hugging, kissing, or eating or drinking from a shared glass, fork, knife, or plate.

However, there can be some risk in sharing household items that might have even tiny, invisible amounts of blood. This includes shaving razors, fingernail clippers and toothbrushes.

Injection Drug Use

The main way hepatitis C is transmitted is through drug injection. The Centers for Disease Control estimates that over half of people who have injected drugs for five years or more are infected with hepatitis C. Because so many injection drug users are infected with hepatitis C, and you cannot tell by looking at someone if they're infected, you should be very careful if you inject drugs.

Sharing syringes for injection is the riskiest activity for getting hepatitis C. You can also get hepatitis C from other materials used to inject drugs. This includes cookers, cottons, filters, and ties. Amounts of blood too small to see can be enough to transmit hepatitis C, so it is important to never share any materials used to inject drugs.

Better public access to clean needles reduces the spread of hepatitis. In some states, adults can purchase new syringes in pharmacies without a prescription. Some communities have started needle exchange programs to give free, clean syringes to people so they won't need to share. The North American Syringe Exchange Network has a web page listing several needle exchange programs at www.nasen.org/.

What About Tattooing?

Tattooing can transmit HCV if safe practices are not followed. Unsafe practices are especially likely if tattoos are done on the street, or in prison.

If you decide to get a tattoo, check the safety procedures. These include:

• Using new needles
• Sterilizing any tools or materials that might come into contact with blood
• Disinfecting all work surfaces
• Using new gloves for each client
• Using new ink pots for each person (HCV can survive in tattoo ink)
• Protecting fresh tattoos so that blood is not transmitted
• Carefully disposing of everything that might have blood on it

Transmission From Mothers to Children

HCV can be spread from a mother to her child during pregnancy or delivery, although this only happens in about 1 out of 30 cases. This is called "vertical transmission." A baby can also be infected by drinking an infected woman's breast milk if mother's breasts (nipples) are cracked and bleeding.

Health Care Workers

Exposure to HCV-infected blood can cause infection through an accidental contact with a needle, or if the blood comes into contact with an open cut or sore, or with the eyes. Healthcare workers should follow standard procedures to avoid contact with possibly infected blood.

Can HCV Be Spread by Sexual Activity?

HCV is not commonly spread through sexual activity. However, sexual practices that cause even minor bleeding can spread HCV. Vigorous intercourse, fisting, anal sex or other activities that draw blood can transmit HCV.

People who have a sexually transmitted disease such as HIV are more likely to transmit hepatitis C through sexual activity. Any open sores, such as those caused by herpes or syphilis, increase the risk of transmission.

What if I've Been Exposed?

Hepatitis C might not cause any symptoms. If you think you have been exposed, you should get tested.

The Bottom Line

The main way HCV is spread is through contact with infected blood. Even tiny amounts of blood, too small to see, can transmit HCV. Injection drug users are at high risk of HCV infection. Tattooing and sexual activity carry some risk of HCV transmission. HCV-infected pregnant women can pass the infection to their new babies, although the risk is low (about 3%).