Hepatitis C (HCV) is transmitted when the blood of an infected person passes into the blood of an uninfected person. Hep C is most easily spread through direct blood-to-blood contact, such as:

  • Sharing needles and other equipment (paraphernalia) used to inject drugs. Injection drug users (IDUs) who share needles, syringes and paraphernalia associated with injecting are at the highest risk of HCV.
  • Blood transfusions and organ transplants before July 1992. Widespread screening of the blood supply in the United States began in 1992.
  • Sexual contact with someone who has HCV. The risk of becoming infected with hepatitis C through unprotected sexual intercourse is low-but it is still possible. HCV sexual transmission risk is higher among those who are HIV positive and in men who have sex with men (MSM). Sex with multiple partners, having a sexually transmitted disease, and rough sex may increase the risk of transmitting HCV sexually.
  • Having an HCV-positive mother. Women who are infected with hepatitis C have a 6 percent chance of passing the virus along to their babies during pregnancy or delivery. The risk increases significantly if the woman has HIV, hepatitis B or a high HCV viral load (the amount of HCV in a measurement of blood). The hepatitis C transmission risk is doubled or tripled in women with HIV. It is unlikely that hep C can be transmitted through breastfeeding or breast milk.

Three out of four people with chronic hepatitis C infection were born from 1945 through 1965. Baby boomers are five times more likely to have hepatitis C than adults born in other years are. The CDC recommends that people born in those years get a one-time blood test for hepatitis C.

Risk Factors

You may be at risk for hepatitis C and should contact your health care provider for a blood test if you:

  • Were born between 1945 and 1965, regardless of any other HCV-related risk factors
  • Were notified that you received blood or an organ from a donor who later tested positive for hepatitis C
  • Have ever injected illegal drugs, even if you experimented only a few times many years ago
  • Received a blood transfusion or solid-organ transplant before 1992
  • Received a blood product for clotting problems before 1987
  • Have HIV
  • Have ever been on long-term kidney dialysis
  • Have evidence of liver disease (e.g., persistently abnormal liver function tests)
  • Have an HCV-positive mother
  • Have been exposed to HCV through your occupation (Note: The risk to health workers of acquiring HCV following a needlestick injury is quite low, averaging 1.8 percent)

Although the risk is uncertain, you may also be at risk if you:

  • Have ever gotten a tattoo or piercing in a nonprofessional setting where equipment such as ink, inkwells or needles were used and potentially unsterilized
  • Have had multiple sexual partners or sexually transmitted diseases
  • Have ever inhaled cocaine or shared other non-injecting drugs

Hepatitis C is not transmitted by casual contact such as coughing, kissing, sneezing or sharing food, beverages or utensils.

Last Reviewed: August 1, 2023