Is Hepatitis C Contagious? The Ultimate Guide

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Hepatitis C is an infectious virus that frequently causes chronic liver disease. The World Health Organization (WHO) estimates that, worldwide, 71 million people have chronic Hepatitis C.

Due to the high cost of treatment and its potentially severe health consequences, Hepatitis C is a major public health concern. Consequently, concerns about Hepatitis C contagion are valid and need to be thoroughly understood.

The impact of Hepatitis C infection can be severe, causing many to question if they are vulnerable. While specific situations present a risk of transmission; normal, everyday contact with others does not spread the Hepatitis C virus.

Hepatitis C is transmitted when the virus in infected blood from one person contacts and infects the blood of an uninfected person. Because casual contact does not spread infected blood, those with the virus do not need to socially isolate themselves.

The virus is not normally found in:

• urine
• semen
• vaginal/cervical fluids
• feces
• saliva

However, injury or illness may cause some of these substances to be contaminated with blood.

In nearly half the cases of Hepatitis C, the infected individuals cannot identify the source for their infection. While it is believed most cases are due to risk factors involving contaminated blood, there remain unidentified modes of transmission.

To clarify how contagious Hepatitis C is (or is not), four categories will be described:

1. How the virus is not transmitted.
2. How it is most commonly transmitted.
3. Other ways transmission can happen.
4. Activities that present an extremely low risk of transmission.

1) Hepatitis C is NOT spread via:

• Sneezing or coughing
• Holding hands or hugging
• Closed-mouth (dry) kissing
• Sharing drinks or food

2) The most common route for spreading Hepatitis C today:

• Drugs – Sharing needles or other equipment to prepare or inject drugs can be tainted with microscopic amounts of infected blood. This includes needles, cookers, cotton, and nasal straws. According to the Centers for Disease Control, 90 percent of new Hepatitis C infections globally come from injection drug use. One of the factors making this the most common route of transmission is that the Hep C virus can survive for over two months in a syringe. For more information, read Hepatitis C Survival: Syringe Specifics.

3) Other ways Hepatitis C transmission can happen:

• Transfusions + Organ Transplants – Before 1992, Hepatitis C was commonly spread through blood transfusions and organ transplants. After 1992, widespread screening of the blood supply in the United States virtually eliminated this source of infection. Although, due to the shortage of organs available for transplant, there is a possibility that transplants could come from a Hepatitis C-infected donor. In these cases, the new organ recipient is treated with antiviral HCV medication.
• Needles – Besides needles used for injecting drugs, there is a chance of Hepatitis C contagion from a non-sterile needle. Acupuncture, piercings, and tattoos are safe when done by a licensed professional who uses only new, single-use, or sterilized needles. Unfortunately, illegitimate businesses/individuals may not always use new, sterile needles. Surgical and diagnostic medical equipment that comes in contact with the blood is also a potential source of contagion if not properly sterilized between patients. Healthcare workers that have a needle stick accident are at risk if the needle was previously used on someone with HCV.
• Birth – Approximately 6 in every 100 infants born to mothers with the virus will inherit it. Known as vertical transmission, factors that increase this risk include the mother having a high viral load, newborn contact with the mother’s blood during childbirth, and the mother being co-infected with HIV. In addition, mothers with Hepatitis C who breastfeed can spread the virus if her nipples are cracked or bleeding.
• Drug Pipe – Sharing a pipe or other device used to smoke is a poor method of transmitting the Hepatitis C virus. However, for those with cracked or bleeding gums or lips, passing a smoking device around poses a contagion risk. For more information, read Smoking Pipes May Transmit HCV.

4) Activities that present a very low risk of Hepatitis C transmission:

• Saliva transfer – Sharing a toothbrush or open-mouth kissing facilitates the sharing of saliva. The likelihood of transmitting Hepatitis C through saliva is very rare, but microscopic bits of blood can present a small risk.
• Sharing certain personal hygiene items – The likelihood of transmitting Hepatitis C within your household is very low, but it is possible if personal hygiene items are shared. Anything that could be contaminated with blood, like toothbrushes, razors, cuticle scissors, and nail clippers have the potential to be a contagion vehicle.
• Can hepatitis c be transmitted through sex? – Although sex will often find itself on a list of potential routes for Hepatitis C transmission, this is extremely rare. Factors increasing the risk of sexual transmission of Hepatitis C include co-infection with HIV, sexual techniques that damage mucosa, acute Hepatitis C infection, high Hepatitis C viral load, and those with multiple sexual partners. There is also a small a risk of transmitting Hepatitis C via oral sex (cunnilingus, fellatio or analingus) when there is any blood or breaks in the affected skin. Every single potential scenario of how Hepatitis C can be transmitted may not be covered in the examples listed above. This is because there are many possible ways for infected blood to make contact with someone’s bloodstream.

Conclusion

This is easier to comprehend when discussing obvious sources of blood, like a blood transfusion. It is harder to visualize Hepatitis C transmission with miniscule bits of blood, too small for the naked eye to see, like a few blood cells on a razor.

It only takes a microscopic quantity of infected blood to transmit Hepatitis C. HCV is contagious, but not in the way a cold or flu is. Instead, the risk of Hepatitis C transmission is dependent on the ease of blood from an infected person transferring over to the blood of another.