Hepatitis C

Hepatitis C is an infectious liver disease caused by the hepatitis C virus (HCV).  It causes liver swelling and can lead to serious liver damage. Infections of hepatitis C occur when the virus is able to enter the bloodstream and reach the liver.

There are other kinds of viral hepatitis, such as hepatitis A, hepatitis B, hepatitis D, and hepatitis E. These diseases and the viruses that cause them are not related to hepatitis C, even though they also affect the liver. They may have other, different symptoms and different modes of transmission, which means that there are different ways of spreading the disease and different means of preventing and controlling these diseases.

The incubation period (the time between initial contact with the virus and the onset of the disease) for hepatitis C is usually 6 to 7 weeks, but it can range from 2 weeks to 6 months. Not all people infected with the hepatitis C virus will develop symptoms.  Some individuals may live with hepatitis C for years before symptoms develop. 

For about 60 to 75% of individuals, no symptoms will be experienced (asymptomatic).  

If present, the symptoms of acute hepatitis C infection include fatigue, fever, nausea,  and yellowing of the skin and eyes (jaundice). Symptoms last about 2 to 12 weeks. 

Health Canada states that about 60 to 70% of people with hepatitis C do not develop symptoms until their liver has already been damaged.

About 75% of individuals with an acute infection will develop a chronic condition. With chronic hepatitis C infection, about 25% of individuals will recover on their own (spontaneously). Symptoms of chronic infection include nausea, pruritus (itching), fatigue,  lack of appetite, bleeding and bruising easily, dark urine, swelling and fluid buildup, confusion, drowsiness, and weight loss. 

Blood tests are used to diagnose hepatitis C. Liver function tests can help indicate if there is damage to the liver. 

The hepatitis C virus is spread primarily by exposure to blood.

People may get hepatitis C from needles, through exposure to blood in the workplace, from unsterile equipment used for body piercing, tattoos or acupuncture, exposure to dental or medical practices with poor infection control practices or by sharing personal care items, including toothbrushes, nail clippers, razors, scissors with infected people. Sharing drug paraphernalia such as needles, spoons, pipes, and straws contaminated with blood has also been associated with a risk. The risk of getting this virus from a blood transfusion is minimal, but still exists. All donated blood is screened for the hepatitis C virus.

Hepatitis C has been transmitted between sex partners. It has also been transmitted, although rarely, among household members, possibly because of frequent physical contact with small cuts or skin rashes. An infected mother can pass the virus to her child at birth.

There is no evidence that the hepatitis C virus is spread by casual contact. Sneezing, coughing, kissing, and hugging do not pose a risk for hepatitis C. In addition, there is no evidence that the hepatitis C virus is spread by food or water.

The hepatitis C virus can survive on surfaces outside the body for up to 3 weeks.

In Canada in 2020, the reported hepatitis C rate was 18.4 cases per 100,000 people, as reported by the Public Health Agency of Canada (published in 2023).  This rate includes cases with acute, chronic, and unspecified disease status. 

When treatment is necessary, hepatitis C is generally treated with drug combinations, including antiviral drugs. Some adults will recover on their own within 6 months, but most will require treatment.  

There is no vaccine for hepatitis C, but the vaccines for hepatitis A and B may be recommended to prevent further liver damage.

Hepatitis C may re-occur. 

The risk of acquiring hepatitis C from the workplace depends on the amount of exposure to human blood or blood products and needlestick injuries. In general, occupational groups with increased risk include workers such as healthcare workers, dentists, and laboratory personnel who are repeatedly exposed to human blood and who are at risk of needlestick injuries. Tattooists, body piercers, and those who perform acupuncture may also be at risk. 

There is currently no vaccine for hepatitis C. The risk of hepatitis C can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.

Infection control precautions are the first line of defence to protect workers from hepatitis C and other blood-borne diseases. For this reason, the Public Health Agency of Canada recommends routine practices when there is a risk of exposure to blood or certain body fluids.

Please see the OSH Answers document Routine Practices for more information.