How hepatitis C is caught and passed on
HCV is mainly transmitted when infected blood directly enters another person’s bloodstream. Saliva and tears are not infectious. Semen and genital fluids may be infectious.
As with HIV, you cannot transmit or catch hepatitis C by touching, kissing, hugging, or from sharing cutlery and crockery.
Unlike HIV, which dies in a few minutes outside the body, HCV survives as an infectious virus in dried blood for several days. This is why you should not share items that may contain tiny traces of blood.
HCV can be transmitted by
- Injecting (or snorting) drug use with shared, unsterilised equipment.
- Tattooing or piercing that does not use new sterilised needles and ink.
- Medical or dental procedures with unsterilised equipment, including kidney dialysis (rare).
- Needlestick accidents in health care workers.
- Sharing items that may contain blood, such as razors, toothbrushes, nail scissors and nail files.
- Sex with someone who has HCV.
Hepatitis C can also be transmitted from mother to infant during pregnancy, or during labour and delivery.
People who received a blood transfusion or blood products before the blood supply was thoroughly screened (early 1990s) may have been infected with HCV.
Since then, the risk has been brought down to virtually zero in the UK, Western Europe, and the US. Up to 90% of people with haemophilia who were treated with clotting factors before screening was introduced were infected with HIV and HCV.
In some countries, infections still occur from blood transfusions because blood is not screened thoroughly.
Injecting drug use and HCV
Worldwide, most HCV infections are related to injecting drug use, through sharing needles and other drug injecting paraphernalia.
Hepatitis C is a tougher and smaller virus than HIV. It can live in a syringe for several days to weeks, and can be transmitted through shared needles and other injection equipment, such as cookers, cotton, water, measuring syringes and ties.
Cleaning syringes with bleach reduces the risk for HIV transmission, but it is less effective against hep C. Using clean needles and your own
works each time you inject stops both HIV and HCV transmission (and reinfection).
It also reduces the risk of other infections.
HCV and other (non-injecting) drug use
Hepatitis C is more common among non-injecting drug users than the general population. It is not clear why.
It may be possible to catch HCV from sharing straws or rolled bank notes for snorting drugs, and maybe from crack pipes. Sharing these items is therefore not recommended.
Transmission of HIV and hep C differ, particularly in terms of injection drug use … because hep C is not just transmitted by sharing a needle, and HCV is much more infectious than HIV. So, I know many people who are taking exactly the same measures to prevent transmission of both, but we know that’s not enough to prevent HCV. Sometimes people make decisions based on insufficient information, both in terms of HCV prevention and treatment. I also worry about sharing a rolled up note when I do coke – but it doesn’t stop me from doing it or my friends from being willing to share. I guess this all comes down to individuals agreeing to own and share risks that they feel to be acceptable … these risks feel ok most, but not all of the time