- Hepatitis C is a liver infection caused by the hepatitis C virus (HCV) that can lead to chronic infection causing cirrhosis, liver cancer, liver failure and death if left untreated.
- The number of reported acute hepatitis C infections have increased by more than fivefold from 2010 to 2020, primarily due to increased injection of opioids and other drugs.
- Safe and effective treatments can cure hepatitis C in almost everyone who takes them and can reduce risk for long-term complications, such as liver cancer. They are called direct acting antivirals or DAAs.
- One-time universal hepatitis C screening is recommended for all adults aged 18 years and older and for all pregnant women during each pregnancy.
- Regular hepatitis C testing is recommended for people with ongoing risk factors.
What Is Hepatitis C?
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is a blood-borne virus. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. For some people, HCV infection is a short-term or acute illness but for more than half of people who become infected with HCV, it becomes a long-term, chronic infection. Chronic HCV infection is a serious disease that can result in long-term health problems, even death. The majority of infected people might not be aware of their infection because they do not have any symptoms. There is no vaccine for hepatitis C. The best way to prevent HCV infection is by avoiding behaviors that can spread the disease, especially injecting drugs.
How Many People Have Hepatitis C?
During 2013-2016 it was estimated that about two and half million people were chronically infected with HCV in the United States. The actual number may be as low as 2.0 million or as high as 2.8 million.
Globally, hepatitis C is a common blood-borne infection with an estimated 58 million people chronically infected according to the World Health Organization.
Who Is Most Affected?
New HCV infections are most common among people who inject drugs. In 2020, 66% of new hepatitis C cases, with risk information provided, reported injection drug use. The number of newly reported chronic hepatitis C cases was highest among males and among people aged 20-39 years and 55-70 years.
Recent Increases in Hepatitis C Infections
Between 2013 and 2020, the reported number of acute HCV infections more than doubled. High rates of new infections were predominantly among young adults aged 20-29 years and aged 30-39 years. The number of cases continues to increase, in 2020 an estimated 66,700 new HCV infections occurred in the United States. For the most recent surveillance data visit CDC Viral Hepatitis Surveillance.
HIV and Hepatitis C Coinfection
HCV infection is common among people with HIV who also inject drugs. Nearly 75% of people living with HIV who report a history of injection drug use are co-infected with HCV. All people who are diagnosed with HIV are recommended to be tested for HCV at least once. People living with HIV are at greater risk for complications and death from HCV infection. Fortunately, direct acting antivirals that are used to treat HCV work equally well in people with and without HIV infection. For more information about HIV and HCV coinfection, visit the HIV.gov’s pages about hepatitis C and HIV coinfection.
How Is Hepatitis C Transmitted?
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
Hepatitis C Prevention
There is no vaccine to prevent hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs with non-sterile injection equipment. Hepatitis C can spread when a person comes into contact with blood from an infected person. Injecting drugs is the most common way HCV is transmitted in the United States. For people who inject drugs, community-based prevention programs, such as medication-assisted treatment and syringe services programs, can reduce the transmission of HCV.
Although the risk of sexual transmission of HCV is considered to be low, avoiding unprotected sexual exposure by using condoms has been shown to reduce the chance of sexually transmitted infections.
About 40% of people with chronic hepatitis C are unaware of their infection. The only way to find out if you have an HCV infection is to get tested through a simple blood test. Awareness of hepatitis C status is important because treatments are available that can cure HCV and reduce the chance of developing liver disease and liver cancer.
The following are the CDC Recommendations for hepatitis C screening among adults in the United States:
- All adults aged 18 years and older
- Pregnant women during each pregnancy
One-time hepatitis C testing:
- People with HIV
- People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago
- People with selected medical conditions, including:
- people who ever received maintenance hemodialysis
- people with persistently abnormal ALT levels
- Prior recipients of transfusions or organ transplants, including:
- people who received clotting factor concentrates produced before 1987
- people who received a transfusion of blood or blood components before July 1992
- people who received an organ transplant before July 1992
- people who were notified that they received blood from a donor who later tested positive for HCV infection
- Healthcare, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV-positive blood
- Children born to mothers with HCV infection
Routine periodic testing for people with ongoing risk factors, while risk factors persist:
- People who currently inject drugs and share needles, syringes, or other drug preparation equipment
- People with selected medical conditions, including:
- People who ever received maintenance hemodialysis
Effective Treatments Are Available for Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDC’s National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
Help Raise Awareness About Hepatitis C
The CDC’s Know More Hepatitis Campaign has been developed to provide digital and printed materials to increase awareness about hepatitis C. Check out the campaign and download or order free materials to get started.
Learn More About Hepatitis C
Centers for Disease Control and Prevention, Division of Viral Hepatitis:
National Institutes of Health: