INJECTION DRUG USE
According to the CDC, the top risk factor for HCV exposure is injection drug use that includes sharing of needles, or any other paraphernalia associated with drug injection. Studies have shown that many injection drug users are positive for HCV antibodies after one year of injecting. If you do inject drugs, make sure you’re safe as you can be. Many states have harm reduction or needle exchange programs. Seek them out for anonymous and non-judgmental help. Using un-shared injection equipment, including syringes, cotton, and spoons is the only way to be sure you’re safe. If you’d like to find a rehabilitation or methadone program near you, click here.
BLOOD TRANSFUSION AND BLOOD PRODUCTS
If you received a whole blood transfusion or solid organ transplant prior to June of 1992, you should be tested for hepatitis C infection. You should also be tested if you received clotting factors (common with hemophilia patients) prior to 1987.
KIDNEY DIALYSIS
Kidney dialysis patients are at risk for transmission. You may want to consider getting tested for anti-HCV antibodies as your doctor suggests. As with all sorts of invasive procedures, we read in the news that current cases of infection by kidney dialysis tend to occur in “outbreaks,” that is, when a dialysis center experiences a rash of outbreaks due to any number of contamination factors. Knowing your HCV status will allow you to inform your dialysis center to take necessary precautions.
UNPROTECTED SEX - MULTIPLE PARTNERS
This route of transmission is responsible for up to 10% of all HCV infections, and mainly occurs within the injection drug user population. According to the NIH, this statistic may be somewhat inaccurate, as people who use injection drugs are prone to other risks. Although hepatitis C is not a sexually transmitted disease (STD), transmission can occur during sex. Remember, hepatitis C is a bloodborne illness. Partners who have sex in the presence of STDs that cause open sores and bleeding are at highest risk for sexual transmission. Long-term, monogamous couples are usually not advised to use protection. People with multiple partners should always use a latex barrier.
Sometimes, people who have had sex outside marriage or exclusive relationship fear that they have contracted the disease whether actual risk was present or not. Clinicians refer to this as “infection via guilt,” when not infected at all. Some people in this group will test for HCV or HIV regularly, believing their activities have brought deserved illness upon themselves. If you suffer from compulsive sexual behavior, there are a multitude of therapists who will work with your behavioral issues.
LOW-RISK GROUPS
Military service, needle-stick accidents with an infected person, being born to a mother infected with HCV, and sharing personal hygiene items are all at low risk for infection. People in this group should consult their doctors for advice on testing for antibodies. While people with tattoos and body piercings are also at risk, those who have gotten tattoos or piercings in a commercial setting usually don’t need to worry. “Jailhouse,” or “street” tattoos and piercings are at higher risk, especially if the implements used were shared by others.
STATISTICAL BREAKDOWN OF RISK
High Risk
- Injection drug users who have shared needles or other injection paraphernalia (even if only once, many years ago)
- Blood transfusion before June, 1992.
- Clotting factors (as with hemophilia patients) before 1987.
- Hemodialysis for kidney failure (risk is determined by duration of treatment).
Variable Risk
- Sexual transmission: 10 percent overall risk. Hepatitis C is not categorized as a sexually transmitted disease (STD). However, people engaging in unprotected sex with multiple partners are at higher risk than the general population. People with STDs who have open sores and bleeding are at a much higher risk. Latex barriers are considered unnecessary for monogamous couples.
- Military service: 2% overall; However, risk is 10-20% among veterans seeking care in VA hospitals.
- Needle-stick accident from a person with hepatitis C: Considered a potential risk because of skin invasion and blood. Statisically, healthcare workers are at the same risk or slightly lower risk than the general population.
- Tattoo or body piercings: Considered a potential risk due to invasion of skin and bleeding, especially among people who get “street,” or “jailhouse” tattoos not performed in a commercial setting. However, the risk factor for non-commercial tattoos is unknown due to other risk factors in this population segment.
Low Risk
- Vertical transmission (born to an HCV-infected mother): 3-5%
Potential Risk
- Shared personal care items (razors, toothbrushes, etc.) with another person: (Invasion of skin and bleeding)
