What Causes Hepatitis C?
Medically reviewed by Mary Josephine Hessert, DO
Hepatitis C is not hereditary, meaning it is not passed from parent to child. Instead, the hepatitis C virus (HCV) is spread by coming into contact with blood from a person with HCV.
Hepatitis is inflammation of the liver. There are several causes of liver inflammation, one of them being HCV. Hepatitis C is an infectious disease caused by HCV and affects the liver. The condition can cause nausea, general discomfort (malaise), abdominal pain, and more.
More than 58 million people worldwide have HCV. Some people with hepatitis C may not experience any noticeable symptoms. Hepatitis C can last six months (acute) or longer (chronic). Long-term hepatitis C can lead to worse liver complications if left untreated.
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Related: What Causes Shingles?
Risk Factors
Coming into contact with blood from a person with HCV can happen in a variety of ways. The most common way HCV is contracted is through shared needles for drug use, but it can also occur in other ways. The cause for contracting HCV is sometimes never found.
Shared Needles and Other Drug Paraphernalia
Sharing or reusing needles from other people for drug injections can increase your risk of contracting hepatitis C. Sharing straws used for snorting cocaine or other drugs can also transmit HCV through contaminated blood. HCV has been found to remain active within needle syringes for several weeks after contamination.
Needle Exchange Programs
Needle exchange programs (NEP) are free harm reduction programs that accept and properly dispose of used needles and provide new, clean needles. This helps reduce the spread of blood-borne diseases such as HCV and HIV. You can find a list of these programs using the NASEN directory.
Personal Hygiene Tools
Sharing personal hygiene tools, such as razors or toothbrushes, could expose you to other people's blood, which can increase your chances of contracting hepatitis C. It's safest not to share these items and other self-care items that may come into contact with blood.
Tattoos and Piercings
HCV can spread in facilities that fail to sterilize their instruments. Unregulated tattooing and piercing that occur in prisons and other informal settings may put a person at risk of getting hepatitis C.
All needle supplies must be sterilized before use. Do not hesitate to ask for a sterilized package of supplies if a needle doesn't come in a pre-sealed package opened in front of you.
Birthing Parent to Infant Transmission
About 6% of babies to people who carry HCV at the time of birth get hepatitis C. The risk of hepatitis C goes up two-fold when the parent giving birth has both HCV and human immunodeficiency virus (HIV).
Breastfeeding does not transmit the virus from parent to child. The Centers for Disease Control and Prevention (CDC) advises people with cracked or bleeding nipples to stop breastfeeding temporarily until they have healed.
Sexual Behaviors
It's not common, but HCV can spread through sexual transmission. People having unprotected receptive anal sex with more than one partner are at high risk. Using condoms can lower the risk of becoming infected with the virus.
Some people with hepatitis C may not experience any symptoms. It's important you and your partner get tested for HCV.
Getting Tested for Hepatitis C Virus
The CDC generally advises HCV screening for all adults at least once in their life. The agency also recommends pregnant people get screened with every pregnancy unless a healthcare provider determines your chance of getting it is less than 0.1% (1 in 1000).
Blood Transfusions and Organ Transplants
Blood transfusions and organ transplants accounted for about 10% of exposures to hepatitis C before 1992. The risk has decreased to less than one in a million due to donor screening. Talk with a healthcare provider about blood tests to screen for HCV if you received a blood transfusion prior to 1992.
Hemodialysis
Hemodialysis is a common therapy for kidney dysfunction. This treatment pumps blood from the body to an artificial kidney machine to filter out bodily waste products and excess water. Hemodialysis then returns the blood to the body.
The longer you've been receiving hemodialysis, the higher your risk of contracting HCV. There's a very small chance the hemodialysis machine is contaminated with HCV-positive blood.
Healthcare Exposures
HCV transmission can occur in labs or healthcare settings, like hospitals or clinics. People can be accidentally exposed to HCV-positive blood, whether through handling blood samples or medical equipment.
Healthcare workers may be at higher risk of needlestick injuries, which can occur with syringes and needles. Standard precautions by nurses, lab technicians, and other healthcare providers (e.g., wearing gloves) can prevent exposure.
Certain preventive measures have been shown to decrease needlestick injuries by 53% in the operating room. These measures include wearing an extra layer of gloves, using safety features to contain the needle after use, and using clear communication when passing needles to others.
How Hepatitis C Cannot Be Transmitted
You cannot get HCV from the following as long as no blood is involved:
Casual skin contact
Kissing or hugging
Shaking hands
Sharing food, water, eating utensils, or drinking glasses
Sneezing or coughing
Swimming in a pool
Is Hepatitis C Hereditary?
Hepatitis C is not hereditary, meaning it's not a genetic condition passed down from generation to generation within families. There's a low chance that a birthing parent with hepatitis C can pass on HCV to their child when giving birth. A family living together can potentially contract the virus through a break in the skin involving the blood of an infected family member, but the risk is low.
Who Gets Hepatitis C?
Anyone can get hepatitis C if they come in contact with HCV-positive blood. Some people may be more likely to get hepatitis C than others, especially those with risk factors. Rates of hepatitis C can vary by different demographics and location.
Geography
The total number of people with hepatitis C can vary by geography worldwide. The Eastern Mediterranean and European regions have the highest number, with 12 million people having HCV. The Southeast Asian and Western Pacific regions have the second highest number, with 10 million HCV-positive people. The lowest regions are the Americas, with five million people.
Sex
Reported cases of chronic hepatitis C tend to be greater in people assigned male at birth than in people assigned female at birth. Sex hormones may play a role, but more research is needed.
Age
Children are at the lowest risk of contracting HCV unless they come into contact with the virus at birth. Hepatitis C tends to be most common in adults aged 20–39. This age group may be when people start using injectable drugs. Positive cases of hepatitis C have increased substantially among young adults since the 2010s.
Hepatitis C can go undetected for years in some people, especially if they don't show symptoms until the disease results in liver complications. This can lead to the detection of the virus at a later age. New HCV cases in people aged 55–70 are the second most common age group in the United States.
Ethnicity
Hepatitis C rates are most common in Indigenous Americans in the United States, with 2.1 cases per 100,000 population. Asian Americans and Pacific Islanders have the lowest incidence at 0.4 cases per 100,000 population.
Related: What Causes HIV?
A Quick Review
Hepatitis C is caused by the hepatitis C virus (HCV), which can be transmitted from person to person through contact with HCV-positive blood. Hepatitis C is not hereditary. Several factors can put you at higher risk of getting HCV, with needle-sharing during injectable drug use being the most common.
Talk with a healthcare provider about getting screened for HCV. They can provide a diagnosis and any necessary treatments.
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