Who Is at Risk for Hepatitis C?

Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV), a virus transmitted through contact with the blood of someone who is infected. Chronic, long-term infection can result in liver damage, cirrhosis, and/or cancer of the liver.

Chronic hep C infections are often asymptomatic. Without noticeable symptoms, many people who have hep C do not realize they have it unless they are screened for infection. The United States Preventive Services Task Force recommends a hep C screening for everyone between the ages of 18 and 79 years. It is a simple one-time blood test.

Acute and chronic hep C

Hepatitis C is classified in two ways: acute and chronic. Acute hepatitis C occurs within the first six months after initial exposure to the virus. 

Acute hep C cases have been on the rise in the U.S. in recent years, with rates more than doubling from 2013 to 2020, according to the Centers for Disease Control and Prevention (CDC). In 2020, rates were highest among people aged between 20 and 39 years old. Acute hep C was also more likely to occur in:

• People who reported using injection drugs
• Males
• People of American Indian/Alaska Native descent
• People who lived in the eastern and southeastern states  

Hepatitis C can be a short-term illness, but without treatment, acute infection can lead to chronic infection. Chronic hep C is a long-term illness—lifelong, if left untreated—that can lead to serious health problems including liver damage, cirrhosis, liver cancer, and death. In fact, in the U.S., chronic hepatitis C is the most common reason for liver transplantation. 

In 2020, chronic hepatitis C rates were highest among 20 to 39-year-olds and 55 to 70-year-olds, according to the CDC. 

Screening for hep C 

Healthcare experts strongly recommend hepatitis C screening, even without symptoms, for all adults up to age 79, pregnant people, and people with risk factors, such as those who use injectable drugs or have HIV. Since in most cases, the infection doesn’t present any symptoms, people can have hepatitis C for years without knowing it. 

Despite this lack of symptoms, the infection is active, causing inflammation and damage to the liver. More than half of people who become infected with HCV will develop a chronic hepatitis C infection.

Risk factors for hepatitis C

In addition to being transmitted through contact with blood that is infected, Hepatitis C can spread via drug paraphernalia and medical equipment. In rare cases, it can spread via common objects like razors or toothbrushes that may have blood on them. HCV can also spread through sexual contact. People considered at higher risk for hepatitis C include:

• People who have used drugs intravenously at any time in their life
• Healthcare workers exposed to blood or bodily fluids from a patient with HCV, or who have been exposed to blood from being stuck with a contaminated needle or other sharp medical instrument
• Children born to mothers who are infected with HCV
• People who have undergone hemodialysis for kidney disease
• People who have a tattoo or body piercing that was done with a non-sterile instrument
• People who have had a blood transfusion or organ transplant before 1992
• Anyone who has had unprotected sex with a person who has HCV and/or those who have had multiple sex partners; sexual transmission is reported more frequently among men who have sex with men
• People who are HIV positive

People may be tested routinely as long as they have one or more of these risk factors. Anyone who requests a test should also be tested.

Getting screened for hepatitis C

The only way to conclusively diagnose hepatitis C is through blood tests. The best way to be screened for hepatitis C is through your healthcare provider, who will take a blood sample for testing.

Diagnosing hepatitis C is a multi-step process. The initial blood work will screen for HCV antibodies. If this test comes back positive, it means you have been exposed to HCV at some point in your life, and you will have another test to confirm whether you are currently infected with HCV, called an HCV RNA test.

Treatment for hepatitis C

Hepatitis C is curable in most cases. It is treated with anti-viral medications that are taken over a period of two to three months. While these medicines are very effective at treating the disease, they cannot undo liver damage that has already occurred, which is why it is important to be diagnosed as early as possible.