Back to: Hepatitis C, an introduction
The following is not an exhaustive list of transmission or exposure, or an exhaustive list of at-risk behaviours. It is inclusive of the most common modes of transmission and very much captures the common risk behaviours that can lead to exposure. We will look closer at People Who Inject Drugs (PWID) in a later lesson.
Hepatitis C Transmission / or Exposure usually occurs when someone comes into contact with blood from a person who is infected with HCV. You can be infected more than once; this is why anyone with at risk behaviour is encouraged to undergo regular testing. Transmission or exposure can be through;
- Sharing drug injection equipment.
- Sharing of needles and equipment used for illicit drug use is the most common transmission route of HCV.
- Birth.
- Also known as vertical transmission. Of expectant mothers who have HCV infection, 5-6% will pass that infection on to their baby, and of those infected babies 25-40% will spontaneously clear of HCV infection within five (5) years.
- There is no evidence of transmission through breastfeeding though it is suggested when nipples are cracked or blood exposure is possible to not breastfeed.
- Health and Medical care exposure.
- This is not a common occurrence today. It is a risk in underdeveloped facilities / countries where poor sterilization techniques, reuse of equipment, such as injection and intravenous equipment, or health-care professionals not following correct procedure may happen.
- Sexual transmission.
- While not common exposure can occur during sex, this is most common amongst men who have sex with men, people who have multiple sex partners, and those who engage in rough sex.
- The practice of ‘chemsex’ where illicit drugs are used as a sexual stimulant, often with sharing of injecting equipment, carries significant risk.
- The risk increases for those who have a sexually transmitted disease, or are infected with Human Immunodeficiency Virus (HIV), (as many as 30% of those with HIV will have HCV)
- Tattoos and Body Piercings.
- Considered low risk in today’s environment, the significant risk is when tattoo professionals do not follow correct hygiene and sterilization procedures, and tattoos or piercings conducted in informal or unlicensed environments such as prisons or backyard studios.
- Sharing personal items.
- HCV infection can occur from miniscule traces of blood from sharing items such as razors, nail clippers, toothbrushes, and any personal items that have been in contact with infected blood.
- HCV is not spread by sharing eating utensils, hugging or kissing, coughing or sneezing, breastfeeding, or through food or water.
- Household transmission is unlikely and would require exposure to infected blood.
- Blood transfusions and organ transplants.
- Blood transfusion products and donated organs have been screened worldwide for HCV since 1992.
- Any blood transfusion or organ transplant prior to 1992 did carry exposure and infection risk.
Who is at risk of HCV infection or exposure: again, this is not an exhaustive list of who is at risk of exposure to, or infection with HCV. There are reported cases where the mode of transmission was not established.
- People Who Inject Drugs PWID)
- People with HIV infection
- People with certain medical conditions, including those receiving maintenance hemodialysis
- People who received transfusions or transplants prior to 1992
- Healthcare and medical personnel who experience needle stick injury or gross blood contamination
- People, (children) birthed from mothers who had HCV infection at the time of pregnancy or birth.
- For reasons unknown, people who abuse alcohol, and do not inject, show a higher predisposition to HCV infection.
