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Hepatitis C Management: Frequently Asked Questions

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Volume 1 – Transmission of Hepatitis C Virus (HCV)
August 10, 2004

How did I get this disease?

Frequently no one can tell exactly when and how a patient acquired HCV, although there is usually an exposure history that points to the most likely period of time and the most likely source of transmission. For example, if a patient had a blood transfusion in early 1980s, in the absence of any other risks, this is the most likely route and time of transmission.

What are the risk factors for contracting HCV?

These are the most common routes of transmission of hepatitis C virus:

  • intravenous drug use
  • transfusion of blood and blood products
  • occupational exposure to blood (primarily during contaminated needle stick injuries)
  • sexual transmission
  • vertical transmission (from mother to child)

I have hepatitis C. My daughter-in-law is afraid to let me hold or kiss my grandson, age 1. This breaks my heart. Am I infectious?

Transmission occurs by blood-to-blood contact. Casual contact such as hugging, kissing, and holding hands are safe activities for people with HCV.

Is it OK to kiss?

There is no scientific evidence to suggest that hepatitis C is transmitted through kissing; therefore kissing is OK. We suggest avoidance of kissing if one of the two individuals has a sore or open lesion in the mouth or on the lips.

Can I pass this disease to others by kissing or sexual intercourse?

The only way of transmitting hepatitis C in a kiss would be for two people with actively bleeding areas to kiss and exchange blood that way. You can pass this disease to others by sexual intercourse, although this is uncommon. The CDC does not recommend any change in sexual practice (e.g. barrier protection) for monogamous patients involved in long-term relationships. The more sexual partners one has and the "rougher" the sexual practice, the more the theoretical likelihood of having two open lesions.

My husband has hepatitis C, and I am afraid on contracting it from him. We have been married for 16 years.

There is much good news in the answer. While the risk of becoming infected with hepatitis C through sexual relations is not zero, it is very, very low. It is so low, in fact, that most of us who treat patients with hepatitis C hardly ever see sexual partners who are both infected (unless there is some other shared risk such as illicit intravenous drug use). The situation for hepatitis C is much different than it is for hepatitis B, which is much more likely to be transmitted sexually. The Centers for Disease Control and Prevention (CDC) is a federal agency whose responsibility is to protect the public from communicable diseases. They advise that when one partner in a stable one-partner relationship has hepatitis C, there is no need for any change in sexual practice at all. The partner should be informed about the presence of hepatitis C. In the event there are multiple sexual partners, the practice of "safe sex" is recommended.

I have body piercing and tattoos. Do I have HCV?

Most tattoo parlors and body piercing establishments are now regulated by the state and must meet hygenic standards. However, you should be tested for hepatitis B and C.

I never had a blood transfusion or used needles, so where did I get HCV?

Sources of infection include tattoos, body piercings, unprotected sex, surgical procedures. In a substantial number of cases, the source is not known. With careful history taking, the majority of patients will identify a potential risk/source for transmission of HCV. Nevertheless, up to 10% of patients cannot identify a potential source for HCV transmission or any potential risks for acquiring HCV.

Can mosquitoes transmit HCV from one person to another? Is there any study on this mode of transmission?

There is no definite evidence suggesting that mosquitoes can transmit HCV. Theoretically, it is possible that an insect feeding on the blood of an infected individual might transmit the virus to others. At the moment, there is no evidence to indicate that HCV is a mosquito-borne disease.

Is it OK to eat from the same plate used by a person with HCV?

It is fine to eat from the same plate. This will not cause transmission of HCV.

What are the risks of giving HCV to the children, from either the mother or father?

The chance is very slim. Although there are cases of HCV transmission from an infected mother to her newborn infant, these are uncommon (less than 6% of pregnancies in the setting of HCV). Transmission from the parent to child during normal contact has not been reported and is not likely to occur.

Should I tell my wife about this infection?

The risk of HCV transmission is low in those in a monogamous relationship. The Centers for Disease Control advises informing sexual partners of your HCV status. As previously stated, no change in sexual practice is recommended for those in a stable monogamous relationship. Although not universally recommended, some experts do suggest screening a patient's spouse for hepatitis C.