Hepatitis C Prevention and Control

Overview

Hepatitis C is a disease of the liver caused by infection with the hepatitis C virus (HCV). After a decade of well-tolerated, effective treatments being available, prevalence of hepatitis C remains unacceptably high in the United States, with more than 2.4 million people - and as many as 4 million people - with the infection from 2017-2020. 1

One-third of people in the U.S. who have hepatitis C are unaware of their infection.2

How it spreads

The virus usually spreads when someone comes into contact with the blood of a person infected with HCV. The blood might be in amounts too small to see. This can happen in several ways.

Sharing items infected with HCV

Most people get infected with HCV by sharing needles, syringes, or other paraphernalia used for injection drug use.

You can also get infected by sharing razors, nail clippers, toothbrushes, or personal medical equipment like glucose monitors.

Birth

Infants born to people with HCV infection are at risk of infection. Approximately 6% of infants born to people with HCV infection will get hepatitis C, so they should be tested for HCV.

Health care associated outbreaks

Poor infection control has led to outbreaks in health care facilities.

Sex with a person infected with HCV

While uncommon, hepatitis C can spread during sex. Most reported cases of transmission have been among men who have sex with men.

Tattoos or body piercings in unregulated settings

Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with non-sterile instruments.

Who is at risk

Some people with certain risk factors or exposures are at higher risk for hepatitis C and should be tested at least once, and periodically if exposure persists. This includes people who inject drugs or have previously injected drugs, people with HIV, and children born to people infected with HCV.

Certain medical conditions

People who have ever received maintenance hemodialysis and those with persistently abnormal alanine aminotransferase (ALT) levels (an enzyme found within liver cells) are considered at increased risk of HCV infection.

Blood transfusion and organ transplant recipients

Certain people who have received blood transfusions or organ transplants are at risk for hepatitis C, including those who:

• Received clotting factor concentrates before 1987.
• Received blood or other transfusions before July 1992.
• Received an organ transplant before July 1992.

Exposure in health care settings

Health care, emergency medical, and public safety personnel can come into contact with blood that is infected with HCV. This can happen through:

• Needle sticks
• Sharp objects
• Mucosal exposures

Patients can also be exposed to HCV. This can happen through:

• Instruments and devices that are not sterilized properly
• Contamination of intravenous (IV) medications

Prevention tips

There is no vaccine to prevent hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, including:

• Sharing needles, syringes, or other drug equipment.
• Practicing poor or unsanitary procedures in health care facilities.
• Engaging in sexual activity with a person who is infected with HCV.
• Getting unregulated tattoos or body piercings.
• Receiving a blood transfusion or organ transplant from a donor with HCV infection.

Syringe services programs and community-based prevention programs such as medication-assisted treatment centers can reduce the transmission of HCV for people who inject drugs,

Additionally, although the risk of sexual transmission of HCV is low, it's important to use condoms or other protective equipment during sex with anyone including someone who has HCV infection to reduce the risk of transmission.

Why prevention is important

Hepatitis C is preventable and curable, yet in the US, new infections continue to occur, with more than 67,000 new infections estimated in 2022 alone.

Most new infections progress to long-term infection. Without treatment, hepatitis C can lead to liver scarring, liver cancer and even death.

Hepatitis C can be cured. Testing is the first step. Know your status and protect your health. If you have hepatitis C, talk to your doctor right way to start life-saving treatment.

Steps to take when traveling

Hepatitis C infection occurs in nearly every part of the world but is most common in some countries in Asia and Africa. This map shows the global prevalence of HCV infection.

Though the risk to most travelers is low, chances of infection increase if you get a transfusion of unscreened blood, have medical or dental procedures abroad, get tattoos, piercings, or acupuncture with unsterile needles, share injection drug use equipment, or engage in sexual activity with a person infected with HCV.

Make sure to follow these tips while traveling:

Don't:

• Use injection equipment that isn't yours or has been used by someone else.
• Share toothbrushes, razors, or devices that can break the skin.

Do:

• Use sterilized equipment for tattoos, piercings, and acupuncture.
• Sterilize medical and dental equipment.
• Practice proper use of latex condoms during sex.
• Use sterile syringes.

Treatment

Most treatments involve just 8–12 weeks of oral therapy (pills). Treatment cures more than 95% of people with hepatitis C, usually without side effects. Learn more about current US Food and Drug Administration (FDA)-approved treatments for hepatitis C.

The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) recommend treatment for all people diagnosed with hepatitis C, except pregnant people and children under 3.