How are hepatitis C infections transmitted?

Learn the risk factors for contracting the illness, as well as ways to safeguard yourself and others.

young man holds image of liver in front of him

Updated on August 2, 2024.

How do you protect yourself from an infection that usually remains silent until it’s done you serious harm? By learning about its risk factors and taking steps to avoid them. 

Hepatitis C is one such infection. And the most impactful way to lower your risk is to avoid contact with the blood of people who might have the disease. 

Unlike other types of hepatitis, which can be spread through sex or contaminated food, the hepatitis (hep) C virus is nearly always transmitted through infected blood. What’s more, that blood must pass through your skin into your bloodstream to infect you—say, via an injection or an open sore.

Hepatitis C risk factors 

Here are the key facts about the causes of hep C infection:

Drug use is the top risk factor. Sharing drug paraphernalia, including needles and syringes, is the primary way hepatitis C is spread in the United States. Some cases of infection have involved non-intravenous drug use, like sharing straws or pipes to snort or smoke cocaine, methamphetamines, and other hard drugs. 

If you use drugs, never share needles or other equipment with anyone else.

Sexual transmission is uncommon. In general, experts believe that transmission during sex requires contact with blood. In long-term, monogamous couples in which one partner has the virus, the risk of the other partner getting it is very low. You can’t get hep C through kissing or touching, and there’s also no evidence that it spreads through oral sex.

The risk of sexual transmission is higher in men who have sex with men, people who have multiple partners, those who have HIV, and people who have a history of sexually transmitted infections (STIs). 

Whether it’s to protect against hepatitis C or other health issues, it’s wise to practice safe sex. To reduce your chance of infection, try to limit your number of sexual partners or have sex with only one person. Use a condom every time.

Blood transfusions are safe. This was a common way to get the virus before blood screening became available in 1992. Now that all blood products are tested, the risk of infection is less than 1 in 2 million.

Getting a tattoo or piercing? Check out the facility. You can become infected with hep C if contaminated tattoo or piercing equipment is used on you. However, no outbreaks have been linked to licensed, regulated parlors. 

If you get body art, find a trained, professional artist who wears disposable gloves and uses single-use, disposable needle kits. Don’t be afraid to ask what infection control practices the artist uses, particularly how surfaces are cleaned and whether any items are re-used. Look around the work area. If it seems unclean or you see blood anywhere, walk away.

It is possible—though very unlikely—for the virus to spread within a household. When it does, it’s usually a result of direct, through-the-skin exposure to the blood of an infected household member. Hep C isn’t spread by coughing, sneezing or sharing eating utensils. However, don’t share personal items such as toothbrushes and razors, which could carry small amounts of blood.

Article sources open article sources

Liver Foundation. Hepatitis C (pdf). June 2023.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases. Hepatitis C. Reviewed March 2020.
Cleveland Clinic. Hepatitis C. December 9, 2022.
Witt MD, Seaberg EC, Darilay A, Young S, et al. Incident hepatitis C virus infection in men who have sex with men: a prospective cohort analysis, 1984-2011. Clin Infect Dis. 2013 Jul;57(1):77-84. 
Centers for Disease Control and Prevention. Hepatitis C: Hepatitis C Prevention and Control. May 16, 2024.
National Health Service (UK). Causes: Hepatitis C. October 27, 2021.
Justiz Valliant AA, Zubair M, Sticco K. Transfusion Transmitted Disease. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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