Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV). While people with HCV need to take precautions to prevent transmission to others, they do not need to self-isolate.
HCV spreads through contact with blood that contains the virus. This usually means that people only need to stay away from others if they have an open and exposed wound.
This article discusses whether people with HCV need to isolate, how HCV spreads, and the precautions people need to take in healthcare settings and at home. It also explores how long HCV is contagious for and whether it is curable.
Most people with HCV do not need to isolate themselves from others. This is because HCV spreads through direct contact with the blood of someone carrying the virus.
- touching or kissing
- coughs or sneezes
- sharing food or water
- sharing or touching utensils, drink ware, plates, or bowls
- breast milk
The exception to this is if a person is bleeding or has broken skin. This could make some activities risky, for example, kissing, holding hands, or sharing food or drink. In this situation, blood could become mixed with other bodily fluids or transfer from skin to skin.
However, even if someone is bleeding, they do not need to self-isolate. They should follow safety precautions to cover wounds, disinfect blood spills, and prevent others from becoming exposed.
Currently, the most common route of HCV transmission is through injection drug use. Sharing needles with others can expose people to blood that contains HCV. Being born to someone with HCV can also result in transmission from parent to baby.
Other methods of transmission that are less common may include:
- sharing personal items that may have small amounts of blood on them, such as toothbrushes and razors
- unregulated tattooing, which can expose people to unsterilized needles
- accidental needle pricking in healthcare settings
- receiving a blood transfusion or organ transplant, though this is rare in the United States
- having sex with someone who has HCV
It is unclear how often sex transmits HCV, but the risk appears to be low. Certain factors can increase the risk. These include:
- having sex during menstruation or whenever blood is present
- rough sex, which may cause bleeding or broken skin
- having sex with someone who uses intravenous drugs
- having a history of sexually transmitted infections
- having HIV
- having multiple sexual partners
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In some cases, it is not possible to determine how someone contracted HCV. In the U.S., 10% of new HCV cases have no identifiable source.
Universal precautions are guidelines that healthcare professionals follow to protect themselves and others from bloodborne pathogens, such as HCV. In the U.S., the Bloodborne Pathogens Standard 29 CFR 1910.1030(b) requires healthcare workers to:
- treat all blood and bodily fluid as though it may contain pathogens
- use appropriate protective measures when there is a chance of exposure to blood or bodily fluids, such as wearing gloves, gowns, masks, and protective eyewear
- remove and safely dispose of personal protective equipment (PPE), needles, and other devices after procedures
- after removing PPE, thoroughly wash the hands with soap and water
- flush eyes or mucus membranes if they have become exposed to bodily fluids
- never eat, drink, smoke, handle contact lenses, or apply personal products in places where exposure to blood or bodily fluids may reasonably occur
- never keep food or drink in places where they may become exposed to blood or bodily fluids
- perform procedures involving blood and bodily fluids in a way that reduces the risk of these substances spraying, splashing, or generating droplets
- keep healthcare facilities clean and sanitary, disinfecting surfaces that come into contact with blood and bodily fluids immediately, and replacing protective coverings
This is not a full list of universal precautions that healthcare workers need to take. People can find the full standard on the Occupational Safety and Health Administration website.
People can help healthcare workers stay safe, and prevent the transmission of HCV, by notifying medical and dental professionals ahead of treatments that they carry the virus. It is also important to notify healthcare workers if a person could have become exposed to bloodborne illnesses, even if they are not sure whether they have an infection.
At home, work, and school, there are also precautions people can take to reduce the risk of spreading HCV. These include:
- not sharing personal items with others, including toothbrushes, toothpicks, floss, razors, or nail clippers, even if they look clean
- not sharing pierced jewelry items with others, or anything else that enters the skin
- completely covering open wounds until they heal
- avoiding activities that could expose someone to blood while there is an open wound, such as sores in the mouth or cracked lips, which would make kissing risky
- cleaning up blood spills immediately by wearing gloves and disinfecting using a bleach solution
- safely disposing of items used to clean up blood, to dress wounds, or during menstruation in sealed bags
- washing the skin and hair of children who have become exposed to blood containing HCV
Safe sex practices for people with HCV include:
- using barrier methods, such as condoms and dental dams, during sex
- avoiding rough sex and behaviors that could expose someone to blood
- avoiding sex during menstruation
If people have been in a long-term monogamous relationship, they may not need to change their sexual practices. However, people who are HCV-negative should attend routine screenings if they have sex with someone who is HCV-positive.
If a person uses needles regularly, they should:
- get needles from a reputable source, such as a pharmacy or a needle exchange program
- always use new needles for each injection
- never share needles or other used items to administer drugs
- speak with a healthcare professional about help with substance abuse disorder
Always get tattoos, piercings, and injections such as hormone, steroid, Botox, or dermal fillers from a licensed professional.
People with HCV and those who frequently come into contact with people who have bloodborne illnesses may find it useful to keep items around the household or workplace that will help in the event of blood spills.
Depending on the environment and risk of exposure, these could include:
- disposable gloves, gowns, face masks or shields, or protective eyewear
- disposable cleaning cloths, towels, or wipes
- sealable bags to securely dispose of items used to clean up blood, as well as for menstrual or personal care products that may have blood on them
- a cleaning product that contains bleach
- sterile dressings to cover cuts or wounds
- separate sets of tools for nail care, oral care, and cleaning pierced jewelry
People with chronic hepatitis C are contagious for as long as they have the virus. This means that people who do not receive curative treatment are capable of transmitting HCV to others.
The type of DAA a person needs can vary. A doctor can determine which medications or combination of medications are likely to work best.
HCV is the virus that causes hepatitis C. It transmits to others through direct contact with blood. For this reason, isolation is not necessary to ensure others are safe.
HCV cannot transmit through casual contact, through the air, or through sharing food or drink. However, if a person has any open cuts, wounds, or broken skin, they may need to avoid certain activities until the wounds heal.
There are many ways to protect others from HCV at home, school, work, and in healthcare settings. People can get more information on this from their healthcare professional.