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The hepatitis C virus (HCV) is spread through contact with infected blood. Common routes of infection include injection drugs (for example, sharing needles), blood transfusions (before 1992), needlestick accidents among healthcare workers, and any other blood-to-blood contact, such as may occur during sexual activity. Each of these routes of hepatitis C transmission is discussed in further detail below. Because hepatitis C is often not detected for many years after infection, it may be difficult to pinpoint the exact event that caused your infection.
If you don't know how you got the hepatitis C virus, you're not alone. About 30% of people with chronic hepatitis do not know how they contracted the virus. You may not remember having a medical procedure or some other event that might have been related to the infection. Infections may have been caused by unnoticed or forgotten exposure from cuts or wounds. Researchers identify these as "community-acquired" (or "sporadic") infections.
In many ways, it simply does not matter how you contracted hepatitis C:
- Your body's experience of the disease will not be different if it was transmitted through "risky" behavior rather than via blood transfusion or a workplace accident.
- There is no "judgment" made by the disease itself. It's not trying to teach you any lessons, unless they are ones you may already know: any risky behaviors should be avoided, and unsterile needles should be handled and disposed of as safely as possible.
- The goal for your healthcare team is to help you get better. Their focus is not on your past but on your treatment and how to optimize your future health.
Causes for Hepatitis C Transmission
- Blood and Blood Product Transfusions: Until early 1992, tests for detecting the hepatitis C virus in donated blood were not available. Before this time, many infections resulted from certain medical conditions or procedures that required donated blood or blood products (such as packed red blood cells or platelets).
- Needlestick Accidents Among Healthcare Workers: Needlestick injuries can occur from handling hypodermic needles, blood collection needles, and needles used to connect intravenous (IV) delivery systems. These accidents typically happen when workers are recapping needles or when needles are not disposed of properly. There is also a risk of infection due to injury while transferring body fluids from one container to another.
- Injection Drug Use: Today, sharing needles for injection drug use is the most common cause of new hepatitis C infection in the United States, accounting for over two thirds of all new cases. Although repeated use of shared needles significantly increases a person's chances of getting hepatitis C, people can become infected through occasional experimentation with injection drugs or even one-time use.
- Other Blood-to-Blood Contact: Any other activity that involves blood-to-blood contact may allow for the transmission of hepatitis C. Examples include:
- Acupuncture, body piercing, or electrolysis with unsterilized or improperly cleaned needles
- Tattooing with needles that have not been sterilized or that have been dipped into contaminated ink. (If ink is not in individually-wrapped packets, there is a potential for blood to be transferred from one person to the ink and then to another person.)
- Sharing certain personal care items (for example, razors, toothbrushes, nail clippers, or nail files) and other household items that might have blood on them. These items may come into contact with small amounts of blood that may not even be visible.
- Healthcare workers' or other professionals' occupational accidents: fire, police, or emergency medical service workers as well as doctors and nurses (low risk)
- Transmission from a mother to her unborn child (4% to 7% risk for children of women with detectable virus at time of delivery)
- Transmission during hemodialysis treatment
- Blood-to-blood contact during sexual activity between an infected and uninfected partner. (In this context, menstrual blood should be treated as any other kind of blood.) The risk of transmission during sex is not precisely known but is thought to be quite low. The risk of transmission is less than 3% for partners of hepatitis C infected persons involved in a monogamous relationship.
- Intranasal cocaine use through the sharing of straws or other instruments—sharing straws to "snort" cocaine may lead to contact with small amounts of blood through nasal ulcers or scrapes.
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