Hepatitis C is a tricky virus: Some people don’t experience any symptoms at all and clear it from their body within a few months, while others develop a chronic liver infection that can lead to major health problems over time. To understand how to protect yourself from hepatitis C—or, if you’ve been diagnosed, how to avoid transmitting it to someone else—it’s important to understand the different ways the virus can be spread. Keep reading for answers to all your questions on how you get hepatitis C.
Can You Get Hep C from Recreational Drug Use?
The main way hepatitis C is spread is blood-to-blood, says Rena Fox, M.D., a professor of medicine at the University of California, San Francisco, and an internist and hepatitis specialist at UCSF Health. So any activity where you might come in contact with another person’s blood, like sharing needles, puts you at risk.
In fact, sharing needles and syringes is the most common way hepatitis C is spread, says Dr. Fox. “We started seeing the number of new cases per year rise again about four or five years ago, along with an increase in heroin use with the opioid epidemic,” she says. If people become addicted to prescription opiates, but then lose access to them, she explains, they may turn to heroin which often involves sharing needles.
Can I Catch Hep C from Getting a Tattoo?
It’s possible to get hepatitis C through tattooing and body piercings if the facility is unlicensed and equipment isn’t properly sterilized, according to the Centers for Disease Control and Prevention (CDC). It’s not all that different than the way you can get hep C from sharing unsanitized personal items like glucose monitors, razors, nail clippers, or toothbrushes, which all have the potential of coming in contact with a person’s blood. In licensed tattooing facilities though, there’s no documented risk of getting hep C.
Could I Get Hep C in the Hospital?
Before the medical community identified hepatitis C as a dangerous virus, it existed in the blood supply that hospitals used for transfusions or organ transplants. “People got hepatitis C if they received a transfusion before we knew how to test for it,” says Dr. Fox. Today though, blood is screened before being administered to patients, so the odds of getting hep C from it is extremely unlikely.
There are also cases of babies who are born with hep C, but that has nothing to do with hospital itself: If a woman has the virus, there is a 6% chance her infant will be born with it, too, according to the CDC. For that reason, it’s important to be tested for hepatitis C if you are thinking about getting pregnant, and also during pregnancy.
Can I Catch Hep C from Sex?
Understandably, that’s a common question doctors hear. Thankfully, the risk is pretty low, says Dr. Fox. “There have been lots of studies of couples who are discordant—where one person is positive for hep C and one is negative—and sexual transmission between heterosexual partners is very infrequent,” she says. On the other hand, the risk rises slightly with anal sex, where bleeding is more common, and transmission is greater if one partner has HIV.
How Easy Is It to Transmit Hep C?
Here’s the good news: “It’s not easy to transmit hepatitis C without blood exposure, so you really don’t have to worry about hugging or sitting close or anything like that,” Dr. Fox says. “Hepatitis C is in body fluids other than blood, but it’s harder to pass it without blood exchange.”
That said, if you or someone close to you has hepatitis C, certain precautions can keep you extra-safe. For example, if your partner has hep C, “it’s pretty hard to get it while doing normal activities, but you might consider not sharing things that could potentially have blood on it, like nail clippers and toothbrushes,” says John Goff, M.D., a clinical professor of medicine at the University of Colorado School of Medicine and member of the American Liver Foundation’s National Medical Advisory Committee.
Other ways you can’t get hep C? Breastfeeding, kissing, coughing, sneezing, eating or drinking, according to the CDC. Whew!
What Happens in Your Body With Hep C?
Once the virus enters your bloodstream, it heads for your liver. “Hepatitis C is a viral infection, and it’s a virus that lives primarily in the liver,” says Dr. Goff. “The reason it causes trouble is our immune system tries to get rid of it, but the virus mutates quite quickly, so it keeps alluding being caught. The liver gets caught in the crossfire.”
Over time, the chronic infection can lead to serious liver scarring (called cirrhosis) and damage, increasing the risk of life-threatening liver failure and cancer, Dr. Fox says.
Can You Have Hep C and Not Know It?
We said this illness is sneaky, and in fact, most people with hepatitis C don’t have any symptoms at the time they are diagnosed, says Dr. Goff. That makes it difficult to trace exactly where and when someone contracted the virus. Unfortunately, it also gives the virus time to wreak havoc on the liver before you feel sick enough to seek treatment.
“Until we started actively screening the population, patients could be infected with hepatitis C and have absolutely no idea they had it,” Dr. Fox says. “We’ve had to change our screening recommendations over time so that we’re not only testing people who self-report a history of a risk factor.”
Currently, the CDC recommends all adults get screened for hepatitis C at least once in their lifetime, and pregnant women should be screened during each pregnancy. For people with ongoing risk factors—for example, for people who regularly inject drugs or share needles—more frequent testing is recommended.
Can You Get Hep C More Than Once?
Some people think hepatitis C is a “one-and-done” virus—kind of like the chickenpox. But it is possible to get it more than once in your life, Dr. Fox says. “If somebody had the infection, was cured of it, then goes back to the same behavior that got them infected in the first place, they can get re-infected,” she explains. The chance of re-infection is lower though, suggesting that you may develop some degree of immunity after your first infection.
Still though, hepatitis C can lead to severe liver damage if left untreated, so if you’re engaging in behaviors that put you at risk of getting or transmitting hepatitis C, talk with your doctor. A physician can answer your specific concerns and let you know whether or how often you should get screened. Thankfully, curing hepatitis C is easier than ever thanks to new, highly effective drugs—but better yet, you can avoid getting it in the first place!