Hepatitis C Precautions
HCV-infected persons must avoid sharing any items that could have blood on them (toothbrushes, razors, nail clippers), cover all bleeding wounds, never donate blood or organs, and if they inject drugs, must never share needles, syringes, water, or any drug preparation equipment. 1
Blood and Personal Item Precautions
For HCV-infected individuals:
- Never share toothbrushes, dental appliances, razors, or shaving equipment that might have microscopic blood contamination 1
- Cover any bleeding wounds immediately to prevent others from contacting their blood 1
- Clean blood spills with 1:10 bleach solution (one part household bleach to nine parts water) while wearing gloves 1
- Never donate blood, organs, tissue, or semen and must disclose HCV status before any such donation 1
Injection Drug Use Precautions
For persons who inject drugs (the leading source of HCV transmission):
- Stop drug use entirely and enter substance abuse treatment including relapse prevention programs 1
- If continuing to inject, never reuse or share syringes, needles, water, cotton, or any drug preparation equipment 1
- Use only new sterile syringes from reliable sources (pharmacies) for each injection 1
- Use new sterile filters and disinfected cookers to prepare drugs 1
- Clean injection sites with new alcohol swabs before each use 1
- Dispose of syringes in puncture-proof containers after single use 1
- If equipment has been used by others, clean with bleach and water first (though new sterile equipment is strongly preferred) 1
Sexual Transmission Precautions
The risk of sexual transmission is low but varies by situation:
- Persons in long-term monogamous relationships do not need to change sexual practices or use barrier protection because transmission risk is essentially negligible (approximately 0-0.6% per year) 1, 2
- Persons with HIV/HCV coinfection, multiple sexual partners, or sexually transmitted infections must use latex condoms consistently due to substantially higher transmission risk 1, 2
- Men who have sex with men, particularly with HIV coinfection, face elevated risk and should use barrier precautions 2
- Anal intercourse poses higher risk than vaginal intercourse due to increased mucosal trauma and bleeding 2
Pregnancy and Breastfeeding
HCV-positive women do not need to avoid pregnancy or breastfeeding:
- Vertical transmission occurs in approximately 5% of births at the time of delivery with no preventive treatment available 1
- Mode of delivery (cesarean vs vaginal) should not be determined by HCV status as it does not affect transmission risk 1
- Breastfeeding is permitted unless nipples are cracked or bleeding 1
- Infants born to HCV-positive mothers should be tested for HCV and monitored for chronic liver disease 1
Healthcare and Occupational Precautions
For healthcare workers and those with occupational exposure:
- Standard barrier precautions and engineering controls must be implemented to prevent blood exposure 1
- Protocols for reporting percutaneous or mucosal blood exposures must be in place 1
- Baseline testing within 48 hours of exposure including HCV RNA, HCV antibody, and ALT 1
- Universal precautions are essential for all healthcare settings including hemodialysis and endoscopy where nosocomial transmission has been documented 3, 4
Liver Protection Measures
To prevent further liver damage:
- Avoid all alcohol consumption as it accelerates liver disease progression 1, 5
- Do not start new medications (including over-the-counter and herbal products) without physician approval 1
- Get vaccinated against hepatitis A and B if not immune, particularly if liver disease is present 1
Social and Daily Living
Important clarifications to prevent unnecessary isolation:
- HCV is NOT spread by sneezing, hugging, coughing, food, water, or casual contact 1
- Sharing eating utensils or drinking glasses is safe 1, 3
- Persons should not be excluded from work, school, childcare, or other settings based on HCV status 1, 6
High-Risk Population Monitoring
Annual HCV RNA testing is recommended for: