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What causes hepatitis C?

Medically reviewed by Neka Miller, PhD on January 21, 2021. 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.


The hepatitis C virus can have serious effects on a person's health, and the CDC reports that nearly 2.4 million Americans (or about 1 percent of the adult population) lived with hepatitis C from 2013 to 2016. So what causes hepatitis C? Keep reading to learn the answer to that question—plus discover how it spreads, signs and symptoms of hepatitis C, and more.


Take the Everlywell at-home Hepatitis C Test to check for hepatitis C from the privacy and convenience of home.


What is hepatitis C?

Hepatitis C, often referred to as “hep C” or HCV (for “hepatitis C virus”), is a type of viral infection that most prominently affects the liver. The severity of a hepatitis C infection can vary widely. Acute hepatitis C often shows no or mild symptoms, which is often why it can go undiagnosed. Any symptoms that do appear from an HCV infection can occur one to three months after initial exposure. These symptoms can include:

  • Fatigue
  • Nausea
  • Fever
  • Muscle aches
  • Jaundice (yellowing in the skin and eyes from bile buildup)
  • Pain in the abdomen
  • Dark urine
  • Clay-colored stools
  • Joint pains

Hepatitis C infections can also appear in chronic (long-lasting) forms if it goes untreated, leading to lifelong health issues like liver damage or—ultimately—liver failure.

Related: 7 signs of hepatitis C to be aware of

Although not all acute forms of hepatitis C become chronic, all chronic hepatitis C infections start as acute infections. Similar to its acute version, chronic HCV is a “silent” virus that can exist in your body for years without showing any noticeable signs or symptoms. Unfortunately, it’s often only diagnosed when the infection has progressed to advanced liver disease, during which the virus has caused significant liver damage. This can lead to other serious illnesses, like cirrhosis of the liver (liver scarring), liver failure, and even liver cancer.


You can easily check for hepatitis C from the convenience and privacy of home with the at-home Hepatitis C Test. Note that the Centers for Disease Control and Prevention (CDC) recommends hepatitis C screening at least once for all adults age 18+.


For some people, the HCV infection will stay dormant in the body for about six months before going away on its own (a process known as spontaneous viral clearance). However, most people (roughly 75 to 85 percent of cases) will develop chronic hepatitis C.

What causes hepatitis C?

As mentioned above, hepatitis C comes from a virus—the hepatitis C virus. Globally, there are currently seven known HCV genotypes, which are categories of the virus that share the same genes. The virus can be further broken down into over 67 known subtypes. Types 1a and 1b are the most common, particularly in North America, Europe, and Japan.

The HCV genotype and subtype generally do not matter in terms of how the virus progresses, though some evidence shows that genotype 3 causes liver disease to progress more quickly. However, the viral genotype can determine the type of treatment options available to you.

How does hepatitis C spread?

The hepatitis C virus spreads when any blood that is contaminated with the virus enters the bloodstream of an uninfected individual. This most commonly occurs when people share contaminated needles or syringes used for injecting drugs. However, hepatitis C can also spread via:

  • Tattoo or piercing needles that have not been properly clean and sterilized
  • Blood transfusions and organ transplants performed before 1992
  • Medical procedures where healthcare professionals have not performed proper sterilization steps

A mother with hepatitis C can also potentially pass the infection to her baby during birth. This occurs in about 6% of the infants born to a mother with hepatitis C.

Essentially, you can get hepatitis C from sharing any personal item that came into contact with infected blood. If that infected blood then enters your own bloodstream, the infection can spread. This means that people can potentially get infected from sharing glucose monitors, nail clippers, razors, or even toothbrushes—though these are rare routes of transmission.

Can hepatitis C spread through sex?

In some cases, hepatitis C can be transmitted via sexual contact—though this isn’t the most common mode of transmission. As hepatitis C infection involves blood-to-blood contact, this is only possible during intercourse that has an increased potential for exposure to blood. Thus, any sexual activity that increases exposure to blood will naturally increase the risk of HCV transmission.

This most often includes having unprotected intercourse during menstruation and having unprotected anal sex, which is more likely to cause bleeding and microtears. Note that sharing drug injection equipment (such as needles) with your sexual partner presents a much higher risk of transmission than just having unprotected sex.

Transmission rates are higher among partners who have tested positive for HIV. This is because HIV increases the viral load of hepatitis C, which means a greater amount of the virus is present in the infected person.

Other sexual behaviors that can increase your risk of HCV transmission include:

  • Sharing sex toys used anally
  • Having multiple sex partners
  • Rough vaginal sex that could contribute to tearing and bleeding in the penis or vagina

Fingering and oral sex generally carry low risks for transmission—but it’s still important to be careful, especially if you or your partner have any open sores.

How hepatitis C doesn’t spread

Hepatitis C only spreads through blood-to-blood exposure. It is not like the common cold or flu, so it cannot be transmitted via:

  • Hugging
  • Kissing
  • Holding or shaking hands
  • Casual contact
  • Coughing, sneezing, or other respiratory modes of transmission
  • Sharing food, drinks, or eating utensils

Preventing hepatitis C transmission

Although hepatitis C is now curable, it’s best for your health to avoid contracting the virus in the first place. The best way to prevent hepatitis C is to avoid any behaviors that can result in making contact with another person’s blood. Do not share needles, syringes, or other injection equipment. If you get a tattoo or piercing, make sure you choose a reputable establishment. Consider asking about sterilization procedures and check to see that they open new needle packs in front of you.

Even with the low risk of hepatitis C transmission via sex, it’s a good idea to consistently practice safe sex using a condom, dental dams, and/or other barriers. As STDs can increase your risk of hepatitis C infection, regularly testing for STDs is an effective preventative step you can take.

A good proactive step to preventing hepatitis C infection—or its long-term health complications—is to get tested for HCV. A simple blood test in your healthcare provider’s office can accurately determine if you have hepatitis C. Aside from peace of mind, knowing if you have the virus can help you seek treatment before the infection has an opportunity to cause serious harm to liver function.


The Everlywell Hepatitis C Test offers a convenient, at-home method for determining if you have been infected with the hepatitis C virus. Sample collection is easy, and everything you need for sending your sample to a lab for testing is included with the kit (including a prepaid shipping label).


References

1. CDC Estimates Nearly 2.4 Million Americans Living with Hepatitis C. Centers for Disease Control and Prevention. URL. Accessed January 21, 2021.

2. Testing Recommendations for Hepatitis C Virus Infection. Centers for Disease Control and Prevention. URL. Accessed January 21, 2021.

3. Hepatitis C. Mayo Clinic. URL. Accessed January 21, 2021.

4. Hepatitis B. Planned Parenthood. URL. Accessed January 21, 2021.

5. Hepatitis C Questions and Answers for the Public. Centers for Disease Control and Prevention. URL. Accessed January 21, 2021.

6. Hepatitis C: How common is sexual transmission? Mayo Clinic. URL. Accessed January 21, 2021.