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Hepatitis C Transmission: How Does Hepatitis C Spread?

Updated January 17, 2024. Medically reviewed by Neka Miller, PhD. Written by Kathryn Wall. 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.

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Hepatitis C is a liver infection caused by the hepatitis C virus, or HCV. You might be wondering: how is hepatitis C transmitted? HCV transmission occurs when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected.

Knowing about the different ways HCV is transmitted can help you avoid getting this virus. You can also easily check for hepatitis C—from the comfort of home—with the Everlywell at-home Hepatitis C Test.

Here’s more about how hepatitis C spreads, symptoms, and long-term health complications. But let’s first go over current hepatitis C screening recommendations.

Hepatitis C Screening Recommendations

According to the CDC, adults age 18 and above should get screened for hepatitis C at least once. The CDC also recommends testing during every pregnancy among pregnant women.

Hepatitis C testing is especially important for men and women born between 1945–1965 because people in this age group—the baby boomer generation—face a particularly high risk of having hepatitis C. It’s estimated that 3 out 4 Americans with hepatitis C are baby boomers.

It’s not completely clear why baby boomers are much more likely to have hepatitis C, but experts have identified some possible factors. Compared to other generations, a higher percentage of people born between 1945–1965 may have tried injection drug use during early adulthood (in the 70s and 80s). Plus, blood used for transfusions wasn’t routinely screened for hepatitis C before 1992, adding further risk of infection among baby boomers.

How Is Hepatitis C Transmitted?

Any activity or behavior that exposes you to the blood of a person with the hepatitis C virus can put you at risk for this infection. Here are the most common hepatitis C transmission routes.

Blood Transfusions

Having a blood transfusion in a country that does not screen its blood supplies for hepatitis C can lead to transmission of the virus. Anyone in the U.S. who received a blood transfusion prior to the year 1992 is also at risk, since blood supplies in the U.S. were not widely or consistently screened for the virus before that year.

Organ Transplants

Anyone in the U.S. who received an organ transplant before 1992 is at a higher risk of having the hepatitis C virus for the same reason as those who received blood transfusions before that year.

Sexual Activity

HCV transmission can occur if sexual activity causes bleeding. HCV may also be transmitted through open sores, cuts, and wounds—such as ulcers (from infections like herpes) that have broken open. The risk of HCV transmission through sexual contact is less common than blood transmission and believed to be low, though the risk increases for those who are infected with HIV or other sexually transmitted infections—or who have multiple sex partners.

Tattoo and Piercing Parlors

People who get tattoos and piercings may be at risk of hepatitis C infection if they have these procedures performed in unregulated settings that fail to properly disinfect needles. The viral transmission occurs when blood from an infected person remains on a needle that is then reused. Before getting a tattoo or piercing, check to make sure the business is properly licensed— and consider asking about its needle disinfection methods to reduce your risk of contracting the hepatitis C virus as much as possible.

Hepatitis C Status of Mother During Pregnancy

Babies who are born to women with hepatitis C may be infected with the virus while in the womb or during childbirth. Nearly six out of every 100 infants born to mothers with hepatitis C infection have the virus, and there is no treatment available to prevent the transmission of HCV at birth.

Personal Items

Sharing or using another’s personal items that may have come into contact with blood—such as razor blades, toothbrushes, water flossers, and tongue scrapers—can increase your risk of contracting the hepatitis C virus when used by an infected person. Avoid sharing these types of personal items with people who may have HCV.

Contaminated Needles

People who inject illicit drugs like heroin or methamphetamine and who share their syringes or needles are at risk for contracting or transmitting the hepatitis C virus. Getting accidentally punctured by a needle that was used by someone with HCV can also lead to HCV transmission.

Common Symptoms of Hepatitis C

Hepatitis C symptoms can show up between 2 and 12 weeks after being exposed to the virus. In many cases, though, there are no symptoms at all—until the infection causes serious health complications. It’s possible for people to have HCV for many years and not know it due to the absence of symptoms.

When hepatitis C symptoms do occur, they may include:

  • Joint pain
  • Abdominal swelling
  • Pain in the upper right part of the stomach
  • Jaundice (yellowing of the skin or whites of the eyes)
  • Nausea
  • Vomiting
  • Loss of appetite
  • Fever
  • Fatigue
  • Itching
  • Dark urine
  • Pale or clay-colored stool

If you are exhibiting one or more of the above symptoms and think you may have been infected with HCV, contact your healthcare provider as soon as possible to receive a proper diagnosis. Hepatitis C is usually diagnosed using an HCV RNA test, which is a blood test that checks for genetic material from the hepatitis C virus that is present in the bloodstream.

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If you’d like to test for hepatitis C from the privacy of home, consider taking the Everlywell at-home Hepatitis C Test. This accurate at-home test is a finger prick test that can be mailed to a lab and produce results within days.

Long-Term Health Complications of Hepatitis C

When left untreated, the hepatitis C virus can develop into a chronic HCV infection. This is associated with serious long-term health complications, and can result in the following.


Cirrhosis is a chronic liver disease that occurs when too much scar tissue builds up inside the liver. The buildup interferes with blood flow and prevents the organ from processing toxins and nutrients. Just like the hepatitis C virus, cirrhosis may not produce symptoms until significant liver damage is present. Symptoms that may be associated with cirrhosis include jaundice, severe itching, and edema.

Liver Cancer

Advanced cirrhosis increases the risk for liver cancer, which is especially common in people infected with the hepatitis C virus. When the liver produces new liver cells to replace scar tissue present with cirrhosis, some cells can mutate into abnormal cells that can become cancerous. Symptoms of liver cancer include jaundice, unexplained weight loss, and pain or tenderness in the upper right part of the abdomen.

Liver Failure

Common symptoms of acute liver failure include jaundice, confusion, sleepiness, and malaise. A liver transplant is usually the most effective way to resolve HCV-related liver failure.

Common Questions About Hepatitis C

What Are the Risk Factors for Hepatitis C Infection?

The most common risk factors for HCV include having HIV, being an injection drug user, undergoing blood transfusions or an organ transplant prior to 1992, and being born between the years 1945 and 1965. Other risk factors for hepatitis C include working in a healthcare environment, getting tattoos or piercings with the use of unsterile equipment, and being born to a mother infected with hepatitis C.

What Are the Most Common Hepatitis C Transmission Routes?

The most common hepatitis C mode of transmission is blood transfusion, followed by injection drug use.

What Are the Least Common Hepatitis C Virus Transmission Routes?

Uncommon HCV transmission routes include having sex with an infected person, being born to a woman with HCV, and sharing personal items that came into contact with an infected person’s blood. Additionally, HCV cannot be transmitted by hugging or holding hands with an infected person.

Can Hepatitis C Transmission Occur via Saliva?

Hepatitis C is spread when blood—not saliva—from an infected person enters the body of a person who is not infected. For that reason, people with hepatitis C infections who engage in kissing and utensil-sharing or who cough or sneeze near others cannot spread the virus in these ways.

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1. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/69/rr/rr6902a1.htm. Accessed February 3, 2020.

2. CDC Now Recommends All Baby Boomers Receive One-Time Hepatitis C Test. Centers for Disease Control and Prevention. https://www.cdc.gov/nchhstp/newsroom/2012/hcv-testing-recs-pressrelease.html. Accessed February 3, 2020.

3. Baby boomers and hepatitis C: What’s the connection? Harvard Health. https://www.health.harvard.edu/blog/baby-boomers-and-hepatitis-c-whats-the-connection-2019050116532. Accessed February 3, 2020.

4. Hepatitis C Questions and Answers for the Public. Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hcv/cfaq.htm. Accessed February 3, 2020.

5. Hepatitis C - children. MedlinePlus. https://medlineplus.gov/ency/article/007672.htm. Accessed February 3, 2020.

6. Lock G, Dirscherl M, Obermeier F, et al. Hepatitis C - contamination of toothbrushes: myth or reality?. J Viral Hepat. 2006;13(9):571–573. doi:10.1111/j.1365-2893.2006.00735.x

7. Hepatitis C. MedlinePlus. https://medlineplus.gov/hepatitisc.html. Accessed February 3, 2020.

8. Symptoms & Causes of Cirrhosis. National Institutes of Health. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes. Accessed February 3, 2020.

9. Liver cancer - hepatocellular carcinoma. MedlinePlus. https://medlineplus.gov/ency/article/000280.htm. Accessed February 3, 2020.

10. Hepatitis C. American College of Gastroenterology. https://gi.org/topics/hepatitis-c/. Accessed February 3, 2020.

11. Viral Hepatitis and Liver Disease. U.S. Department of Veterans Affairs. https://www.hepatitis.va.gov/hcv/background/transmission-modes.asp. Accessed February 3, 2020.

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