Hepatitis C is common in people living with HIV. Between one-quarter
(25%) and one-third (33%) of all HIV-positive people in the United States
are infected with HCV. This means that approximately 350,000 Americans
are living with both HIV infection and hepatitis C.
Injection drug users (IDUs), if they share needles with other people,
are at the highest risk of being infected with HCV – between 50%
and 90% of all IDUs who are infected with HIV are also infected with HCV.
This is because both viruses can be spread easily through blood and blood
products.
To cause a new infection, HCV must pass from the blood of an infected
person into the blood of an uninfected (susceptible) person. In other
words, HCV is most easily spread through direct blood-to-blood contact,
such as:
- Sharing needles and other equipment (paraphernalia) used to inject
drugs.
- Needle-stick injuries and exposure of open wounds or mucous membranes
to infected blood. (Note: The risk of transmission in the healthcare
setting is actually quite low – 4% to 10% risk through a needle-stick
injury involving a needle previously used in someone infected with HCV.)
- Blood or blood-product transfusion (especially prior to 1992).
Unlike HIV, it is generally believed that HCV cannot be transmitted through
semen or other genital fluids, unless blood is present. Thus, the risk
of becoming infected with HCV through unprotected sexual intercourse is
low – but it is still possible. As a result, experts recommend that
people infected with HCV practice safer sex using a protective barrier
(e.g., condoms), especially during intercourse, to protect their partners.
Women who are infected with HCV have a less than 10% chance of passing
the virus along to their babies during pregnancy or delivery, although
the risk increases if the woman’s HCV viral load (the amount of HCV
in a measurement of blood) is high. It is unlikely that HCV can be transmitted
through breastfeeding or breast milk.
You may be at risk for hepatitis C and should contact your healthcare
provider for a blood test if you:
- Were notified that you received blood from a donor who later tested
positive for hepatitis C.
- Have ever injected illegal drugs, even if you experimented a few times
many years ago.
- Received a blood transfusion or solid-organ transplant before July,
1992.
- Received a blood product for clotting problems before 1987.
- Have ever been on long-term kidney dialysis.
- Have evidence of liver disease (e.g., persistently abnormal liver
function tests).
- Have had multiple sexual partners, or sexual contact with an HCV+
person.
- Have an HCV+ mother.
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