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Hepatitis C: A Bloody Burden

Let us not look back in anger, nor forward in fear, but around in awareness. James Thurber

Hepatitis C: A Bloody Burden

Hepatitis C is transmitted via blood-to-blood contact

The hardest part of having hepatitis C was living with the fear that I could infect someone else. This week’s blog discusses hepatitis C transmission—how to avoid getting it, or if is too late, how to keep others safe.

Blood-to-blood contact is how hepatitis C transmitted. Injection drug use is the most common way people acquire hepatitis C. Sharing needles, syringes, and the paraphernalia  used for injection use, including the surface on which the drug is prepared, is highly risky.

Other ways hepatitis C is spread:

  • Contaminated blood, blood products, and organs before July 1992, or from infected blood received in another country
  • Occupational exposure to blood, particularly needlestick injuries
  • Transmission during birth from a hepatitis C-positive mother
  • Sexual transmission rate is low for monogamous heterosexual partners. The risk increases in the presence of sores, blood, or torn tissue. The risk is much higher if there is another sexually transmitted infection, such as HIV or hepatitis B. Men who have sex with men are at greater risk of hepatitis C transmission.

Less commonly, hepatitis C can be spread:

  • Sharing personal items contaminated with infected blood, such as razors or toothbrushes. Hepatitis C is rarely spread in households, but this is a potential risk.
  • During healthcare procedures that involve blood-to-blood contact, especially in foreign countries.
  • Hepatitis C may be spread via drugs that are inhaled or smoked, if there is blood passed on the straw or pipe.
  • Tattoos and body piercing, especially outside of a commercial setting.

If you have hepatitis C, then it is your responsibility to take care not to infect others. For me, this was the biggest burden of having hepatitis C. The thought that I could accidentally infect someone weighed on me whenever I cut myself. I started to bleed after a scab steamed open in a bathhouse in Turkey and I nearly freaked out trying to clean it up. I was sure that I had infected all of Istanbul.

It took years of working in this field for me to see that hepatitis C did not spread as easily as I had feared.  As a nurse, I spent a lot of time reassuring patients that they did not pass hepatitis C to family members after cutting themselves during food preparation, or similar scenarios.

The best way to protect others is to minimize blood-to-blood contact. If you have hepatitis C:

  • Do not donate blood, organs, tissue, or semen.
  • Clean blood spills with bleach.
  • Cover cuts and sores with bandages.
  • Do not share personal items such as toothbrushes, razors, cuticle scissors, or any items that might have blood on them.
  • Talk to your sex partner(s) about the fact that you have hepatitis C. Use appropriate protection if you or your partner(s) are concerned about hepatitis C transmission. Do not engage in sexual practices where they might be contact with blood, such as vampire play or sex with chainsaws. (I made this up. If you are having sex with chainsaws, I don’t want to know about it. I did not make up vampire play.)

Hepatitis C is not spread casually. You can’t get it or give it by sneezing, hugging, holding hands, coughing, sharing eating utensils or drinking glasses, or through food or water. Kissing is safe too, as long as you aren’t both bleeding or kissing chainsaws.

This post first appeared on Lucinda Porter’s blog at Every Day Health, Navigating Hepatitis C

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{ 8 comments… add one }
  • Caroline March 26, 2015, 4:08 PM

    After 18 months I still have no idea how or when I got this horrible disease. I have none, exactly 0, of the risk factors associated with contracting HCV. So I figure it must be easier to get than what experts are telling us. I think that if I could get it that easy it would have to be easy for me to pass it on. I have examined my entire life and have come up empty with how I could have gotten this. If I got this through casual contact then I don’t want to give it to anyone else the same way.

    So for the past year and a half I’ve had very limited physical contact with anyone. I don’t go anywhere anymore but work and home.

    I miss waking up happy and looking forward to the day ahead. I miss hugging my daughter and husband of 35 years, who tested negative by the way. This really baffled my specialist. I think he was hoping that this would explain where I got it from. I miss going out with friends and having fun for no reason. I get up in the morning and hope I somehow get through another day of work. Then on my days off I just stay in bed to sleep since my work days are usually accomplished on 2-3 hours of sleep each night. And getting up seems pointless.

    My husband is the only person who knows and I can’t talk to him about how I feel. I just spend every day thinking about the how and why of it all. With no answers. No one understands why it is so important for me up know this answer, but I need to know what I did to deserve this. In 3 more weeks I will be awaiting news of my 12 week post treatment results. Even if this treatment works the way the dr hopes it will, I know it will always be there, lurking in me. I don’t believe this type of remission can be called a cure. So this is my new life, alone and sad.

    • Lucinda Porter March 27, 2015, 10:19 AM

      Hi Caroline,
      Let’s start with an important part: you don’t have to do this alone. There are millions of us, and we help each other. A good group to try is an online group and you don’t have to use your real name: http://forums.hepmag.com/
      Next, you can still hug your daughter and husband. Hep C is not passed casually.
      As to risk factors – I am guessing that you have one of the #1 risk factors, and that you were born from 1945 – 1965. There was a lot of hep C in our blood supply, and if you happened to go to the dentist or had your blood drawn in the days when there were few precautions, then you may well have been infected that way.
      And finally, if you are cured, hep C won’t always be lurking. If it is gone, it is gone for good. You are either cured or you aren’t. If your results come back nondetectable, you are done. Enjoy the freedom. You will always have the antibody, but that isn’t the virus, just like a picture of the Eiffel Tower isn’t the Eiffel Tower.
      Try to get accurate info – it sounds like you are making yourself miserable over things that aren’t trur.

  • Pam Langford March 27, 2015, 12:04 AM

    Great article as always Lucinda! My only *wish* would be that you change the part about donating organs. We can be organ donors with hepatitis C and/or hepatitis B. They are only used on other HCV or HBV patients but I wouldn’t want anyone to think that we can’t be organ donors. THANKS AGAIN FOR ALL YOU DO! YOU ROCK MY DEAR!!

    • Lucinda Porter March 27, 2015, 10:09 AM

      You are absolutely right Pam. I haven’t heard that transplants occur with active hep B or C, but I know that HCV antibody-positive organs are being offered to HCV patients. I have an article coming out on April 1st in the HCV Advocate, saying exactly that, and I am delighted you popped in with this great reminder. Thanks.

  • Sharon James-Foy March 27, 2015, 11:15 AM

    Thank you for all your hard work.

  • Katie April 1, 2015, 7:27 PM

    Hello again! A few months ago, I commented on one of your blogs. I had just been diagnosed as Hepatitis C positive after a needle stick injury at work (I am an ICU nurse). It was the hardest day of my life. I am in a monogamous relationship with my husband and I also have a very young son. You are right in saying that my greatest fear was giving the virus to the ones I love. I felt like I would never forgive myself if my son or husband ended up positive. When they were initially tested days after my diagnosis, they were both negative. You told me that if I had any questions about retesting to let you know. How often should my husband and son be retested? I feel like I have been left in the dark by my doctor as to what to do next. Three weeks after my positive test, I saw a GI doctor and he ran tests in preparation for me to see a hepatologist. Surprisingly, HCV came up undetectable at that time. I went back for more lab work a month later and it just came back undetectable again. I have never seen the hepatologist so there are a lot of unanswered questions. I was told not to assume I am clear from the virus for 6-12 months. Is there really a chance it will show up again after 11 months of undetectable tests? Or even now after a month of undetectable testing? I was also told “to hold off on trying to have more kids.” Do you have any insight into how long I would need to test undetectable before trying for more children? I’m trying to be patient, but also feel like I have so many questions! I appreciate any insight!

    • Lucinda Porter April 1, 2015, 9:13 PM

      Congratulations on the undetectable result. Here are my answers:
      How often should my husband and son be retested? – There is no need for further testing
      I was told not to assume I am clear from the virus for 6-12 months. Is there really a chance it will show up again after 11 months of undetectable tests? – No Or even now after a month of undetectable testing? – Very unlikely
      I was also told “to hold off on trying to have more kids.” Do you have any insight into how long I would need to test undetectable before trying for more children? I would ask your doc, but I think that it would be just like if you had treatment – if you are undetectable for 3 months, then I’d assume you are free and clear.

  • Aika March 20, 2019, 12:30 AM

    This is worth sharing! People should learn about how Hepatitis C can be transmitted so we can take steps to avoid contracting it. There is currently no vaccine for hepatitis C and while access to HCV treatment is improving, it still remains limited.

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