Can Hepatitis C Be Transmitted Sexually?

Medically reviewed on Nov 17, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Primary Modes Of Hepatitis C Transmission
• Sexual Safe Practices
• Hepatitis C Risks And Symptoms
• Hepatitis C Testing And Treatment
• Assess Your Health With Everlywell
• Related Content

When the virus, hepatitis C (HCV), enters the body, it aims for the liver—an organ that filters harmful substances out of our blood. And this makes a lot of sense because the HCV spreads when we come into contact with infected blood.[1]

To combat the hepatitis C infection, the immune system responds, causing the liver to swell and eventually scar.[1]

There are multiple ways in which hepatitis C is transmitted—one being through sexual activity.[1]

Primary Modes Of Hepatitis C Transmission

Any activity that exposes you to blood infected with the hepatitis C virus puts you at risk. [2]

This can include several activities, from sexual practices to injected drug use. [2]

1. Sexual Activity

Contracting hepatitis C during sex is quite uncommon, but it can still happen. An HCV infection can occur if your partner is infected with the virus and spreads it through an open wound or sore.[3]

That said, there are several factors that can put you at a higher risk of acquiring hep C transmission sexually. These include [3]:

• Having a sexually transmitted infection (STI)
• Having sex with multiple partners
• Having anal sex
• Having sex while menstruating
• Having sex without protection, like a condom
• Having rough sex that causes tears or scratches

Studies have also found that men who have sex with men (MSM) are also at a higher risk of contracting the virus through sexual transmission. [3]

To lower your chances of acquiring hepatitis C through intimacy, avoid any sex acts that may cause bleeding, such as using toys or drugs while having sex. Fortunately, a hepatitis C infection can not be spread through physical contact like hugging or kissing. [2]

2.Blood Transfusion

Worldwide, blood transfusions are one of the main causes of the spread of hepatitis C, particularly in developing countries.4 Fortunately, in the United States, advances in blood transfusion technology and regular HCV antibody (Ab) blood screenings have greatly reduced the number of blood transfusion hepatitis C cases. [5]

In contrast, studies conducted during the ‘60s and ‘70s identified that 25% of patients with the hepatitis C virus were infected through transfusion-transmission.5 These numbers only decreased as medical personnel became more stringent with their donor qualifications. Namely, they excluded those who tested positive for hepatitis B, which is primarily transmitted through sexual activity, and human immunodeficiency virus (HIV). [5]

All that said, hepatitis C can still be transmitted in the early stages of the infection when the virus does not appear on blood screenings. [5]

It’s also believed that the virus can survive outside of the body, within dry patches of blood, for weeks. [6]

3. Injection Drug Use

Sharing unsterilized syringes and needles to inject drugs puts drug users at a significant risk of contracting hepatitis C if they’re using the same equipment as a person with the virus.7 In a study that observed hepatitis rates in 88 countries (which comprises 85% of the global population), researchers found that 0.2% of patients who contracted the virus also injected drugs. [7]

Drug use is considered the leading risk factor for contracting hepatitis C in the United States. And, within the country, a third of young people who inject drugs have been exposed to the virus.[8] Injection drug use is also correlated with opioid misuse, unemployment, poverty, incarceration, and homelessness.

Sexual Safe Practices

If you believe you may be at a higher risk of contracting hepatitis C through your sexual activity, there are several best practices that you can implement to safeguard your health. These include [9]:

• Using protection – First and foremost, it’s always recommended to use a condom. Look for male condoms that are made from latex, rather than natural materials, to avoid breakage. Female condoms typically come in a durable plastic material called polyurethane.
• Limiting sexual partners – Having multiple sexual partners can put you at a higher risk of contracting many other infections, beyond hepatitis C. When engaging in sex with a new partner, take the time to discuss your sexual pasts and partners, STI statuses, and drug use to ensure all potential risks are disclosed.
• Avoiding alcohol and drugs – Using substances like alcohol and drugs can put you at a higher risk of participating in risky sex, such as activity without a condom or rough sex. Before engaging in sexual activity of any kind, check in with yourself and your partner to make sure you’re on the same page about expectations.

Hepatitis C Risks And Symptoms

In addition to risky sexual activity, blood transfusions, and injection drug use, you may be at a higher risk of contracting the virus if you [10]:

• Have been on long-term kidney dialysis
• Regularly come in contact with blood (through healthcare work, for instance)
• Were born to a mother with hepatitis C
• Received a tattoo or acupuncture with unsterilized equipment
• Received an organ transplant from an infected donor
• Share toothbrushes or razors with someone with hepatitis C

When you’re first infected, it’s unlikely that you’ll experience any symptoms that will clue you into the fact that you’ve contracted the virus. After patients have been chronically infected with the virus for a longer period of time, they may experience yellowing of the skin (called jaundice) and, eventually, cirrhosis. [10]

Cirrhosis refers to the scarring of the liver, which can prevent the liver from functioning properly. [10]

Additional symptoms of hepatitis C include [10]:

• Upper right abdomen pain
• Abdominal swelling
• Clay-colored or pale stools
• Dark urine
• Fatigue
• Fever
• Itching
• Loss of appetite
• Nausea
• Vomiting

Hepatitis C Testing And Treatment

If you suspect that you have hepatitis C or have come into contact with a person infected with the virus, schedule an appointment with your healthcare provider. Once you’ve shared your symptoms and medical history, they’ll order a blood test to identify the presence of the hepatitis C virus within your body.[11]

The blood test is called the HCV antibody test. It’ll identify whether your blood has antibodies to fight the virus. These antibodies will typically appear 12 weeks following the time of infection.[11]

Generally speaking, hepatitis C test results take a few days to a few weeks to come back. When they do, you’ll receive one of two results[11]:

• Non-reactive – A non-reactive test identifies that there are no hepatitis C antibodies in your blood and you do not have the virus.
• Reactive – Essentially, this is a positive result, meaning you have been infected with the hepatitis C virus. That said, hepatitis C virus antibodies remain in the blood even after the virus has been eradicated, so a “reactive” test result does not necessarily mean you are currently infected. Accordingly, a follow-up test is typically ordered to verify the diagnosis.

Patients who receive a “reactive” test result must undergo an additional screening called the nucleic acid test (NAT) for HCV RNA, a PCR test. A negative result indicates that the virus is not in your system, while a positive result lets your healthcare provider know that the virus is currently in your bloodstream. [11]

In cases of chronic hepatitis C, in which the liver may be damaged, a healthcare provider may also order one of the following tests to assess liver damage [1]:

• Magnetic resonance elastography (MRE) – Imaging technology allows healthcare providers to noninvasively assess the condition of the liver. Sound waves create a map of the organ to indicate where the liver is stiff, or scarred.
• Transient elastography – This type of ultrasound uses vibrations to assess scarred areas of the liver.
• Liver biopsy – A healthcare provider will insert a thin needle into the liver and collect a tissue sample to assess in the lab for damage. Typically, they’ll use an ultrasound to guide this practice.
• Blood tests – Certain types of blood tests can indicate whether there is any scarring on the liver.

If you’re diagnosed with hepatitis C, your healthcare provider will prescribe an antiviral medication, although the specific type will depend on the unique hepatitis C genotype, your liver damage, any earlier treatments you’ve received, and your medical history. Antiviral treatments can take up to 12 weeks to fully eradicate the virus from your system. [1]

If the virus causes serious liver damage, hepatitis C treatment options may also include a liver transplant. [1]

Assess Your Health With Everlywell

Overall, it’s unlikely to transmit hepatitis C through sexual activity. Although, it’s not entirely impossible, particularly if you engage in sex with an infected partner who is menstruating, anal sex, or rough sex that can cause tears in the skin.

Thanks to blood screenings, the likelihood of contracting hepatitis C through blood transfusions is also quite unlikely in countries like the United States. Rather, people who inject drugs are at the highest risk of getting the virus since shared needles and syringes are rarely sanitized properly.

If you believe you’ve been infected with the hepatitis C virus, Everlywell has your back. Our at-home Hepatitis C Test provides a discreet way to assess your health without needing to make an in-person appointment with your local healthcare provider. With just a quick prick and a postage stamp, you can send your blood sample to one of our CLIA-certified labs. If your test results are abnormal, we’ll connect you with our independent physician network to talk about treatment plans. Or, meet with a licensed clinician via Everlywell to receive online STD treatment.

It’s that simple.

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References

1. Safer Sex Guidelines. Johns Hopkins Medicine. URL. Accessed October 17, 2023.
2. Hepatitis C. Penn Medicine. Published May 2, 2023. URL. Accessed October 17, 2023.
3. Hepatitis C Testing. CDC. Published June 26, 2022. URL. Accessed October 17, 2023.
4. Hepatitis C. Mayo Clinic. Published August 23, 2023. URL. Accessed October 17, 2023.
5. Hepatitis C. WHO. Published July 18, 2023. URL. Accessed October 17, 2023.
6. Sexual Transmission and Viral Hepatitis. CDC. Published September 21, 2020. URL. Accessed October 17, 2023.
7. Selvarajah S, et al. TRANSFUSION-TRANSMISSION OF HCV, A LONG BUT SUCCESSFUL ROAD MAP TO SAFETY. Antivir Ther. Published December 7, 2012. URL. Accessed October 17, 2023.
8. Who's at Risk for Hepatitis C. New York State. URL. Accessed October 17, 2023.
9. Causes -Hepatitis C. NHS. Published October 27, 2021. URL. Accessed October 17, 2023.
10. Trickey A, et al. The contribution of injecting drug use as a risk factor for Hepatitis C virus transmission globally, regionally, and at country level: a modelling study. Lancet Gastroenterol Hepatol. Published April 10, 2019. URL. Accessed October 17, 2023.
11. Mateu-Gelabert P, et al. Hepatitis C virus risk among young people who inject drugs. Published July 29, 2022. URL. Accessed October 17, 2023.