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HCV is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as The most recent surveys of active IDUs indicate that approximately one third of young (aged 18–30 years) IDUs are HCV-infected.

Older and former IDUs typically have a much higher prevalence (approximately 70%–90%) of HCV infection, reflecting the increased risk of continued injection drug use.

However, many have chronic liver disease, which can range from mild to severe, including cirrhosis and liver cancer.

Chronic liver disease in HCV-infected persons is usually insidious, progressing slowly without any signs or symptoms for several decades.

Most persons with chronic HCV infection are asymptomatic.

Health care personnel should understand and adhere to Standard Precautions, which includes Injection Safety practices aimed at reducing bloodborne pathogen risks for patients and health care personnel.

If health care-associated HCV infection is suspected, this should be reported to state and local public health authorities. If HCV is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

The overall incidence rate for 2014 was 0.7 cases per 100,000 population, an increase from 2010–2012.

After adjusting for under-ascertainment and under-reporting, an estimated 30,500 acute hepatitis C cases occurred in 2014.

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