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Unsafe injections, dialysis and transfusions: how hepatitis C spread in India | CION Cancer Clinics
In India, hepatitis C has spread mainly through medical care that was not done safely: reused syringes, older blood transfusions and dialysis. Many people were infected long ago and still feel well. This page explains each route, who should ask for a blood test, and why clearing the virus does not always end the need for liver checks. At CION Cancer Clinics, our specialists help you understand your own risk and plan regular liver checks that fit it.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- How did most people in India get hepatitis C?
- Which kinds of medical care have spread hepatitis C in India?
- I may have been exposed years ago. What should I do?
- What families often believe about hepatitis C, and what is true
- The hepatitis C words you will meet, in plain language
- What this page cannot tell you
- Common questions about how hepatitis C spread in India
The short answer
How did most people in India get hepatitis C?
In India, hepatitis C has mostly travelled through blood, carried by medical care that was not done safely. Reused syringes, injections given with equipment that was not sterile, dialysis, and blood transfusions before donated blood was routinely tested are the main routes.
This matters for two reasons. Many people were infected decades ago, during an illness they barely remember, and have felt well ever since. And hepatitis C can quietly scar the liver for a long time before it causes any symptom, which is how some people first learn about it only when a liver problem or a liver cancer is found.
It is nobody's fault
People who picked up the virus this way did nothing wrong. They went to a clinic for help. The useful question now is who in your family should have a simple blood test.
The good news, and the part people miss
Hepatitis C is now curable with tablets, and low-cost Indian versions of these medicines exist. Clearing the virus stops further damage. It does not undo scarring that is already there, so anyone with cirrhosis still needs regular liver checks afterwards. What curable actually means is explained on its own page.
This page is about how hepatitis C spreads. If you already have a liver cancer diagnosis, start with your treatment team.The main routes
Which kinds of medical care have spread hepatitis C in India?
Every route below involves a tiny amount of one person's blood reaching another person's bloodstream. Ordinary daily contact does not do this.
Reused needles and syringes
For a long time, injections were very common for fevers, weakness and body pain, often from local practitioners. Where glass syringes were boiled poorly, or plastic ones were reused, the virus could pass from patient to patient.
Think back to
- Frequent injections in childhood or youth
- Drips and injections in small clinics
- Any treatment where you did not see a new syringe opened
Blood transfusions before testing was routine
Donated blood in India was not always screened for hepatitis C in the past. Anyone who received blood after an accident, a difficult delivery, surgery or during treatment for thalassaemia or haemophilia in that earlier period should be tested.
Dialysis
People on long-term dialysis for kidney failure share machines and rooms with other patients. When cleaning between patients slips, the virus can spread. Dialysis units are expected to test their patients regularly for this reason.
If you are on dialysis, ask how often your unit checks for hepatitis C and ask to see your own result.Other procedures and shared drug equipment
Dental work, minor surgery and other procedures with poorly sterilised instruments carry a risk. Sharing needles or other equipment for injecting drugs is a major route worldwide. Sexual spread and spread from mother to baby are possible but much less common.
Not sure whether this applies to you?
Ask an oncologistIf this sounds familiar
I may have been exposed years ago. What should I do?
Ask for the antibody test
A simple blood test called anti-HCV shows whether you have ever met the virus. It does not need fasting. Government programmes and private laboratories both offer it.
If it is positive, check for the virus itself
A positive antibody test is not a diagnosis. Some people clear the virus naturally. A second test, the HCV RNA test, shows whether the virus is still active in the blood.
See a hepatologist or physician about treatment
If the virus is active, a liver specialist or physician decides on antiviral tablets. Treatment is short and usually well tolerated. CION's team can coordinate this through partner hepatologists.
Find out how much scarring there is
Blood tests, an ultrasound and often a liver stiffness scan show whether there is fibrosis or cirrhosis. That answer decides whether you need regular liver cancer checks after treatment.
Tell the people who matter
Brothers, sisters or a spouse who had the same kind of treatment, or received blood at the same time, may want testing too. A short conversation now saves years of not knowing.
Commonly believed
What families often believe about hepatitis C, and what is true
"You only get it from bad habits."
In India, most people with hepatitis C caught it through medical care: injections, transfusions, dialysis or procedures. Grandmothers, schoolteachers and children treated for blood disorders have it. Nobody earned it.
"We share food and plates, so the whole family must have it."
Hepatitis C does not spread through food, water, shared plates, hugging, coughing or breastfeeding. Family testing is about shared exposures in the past, such as the same clinic. Living together is not the reason.
"I feel perfectly well, so I cannot have it."
Most people with long-standing hepatitis C feel nothing at all. The virus can scar the liver slowly for decades before any symptom appears. A blood test is the only way to know.
"Once the virus is gone, the liver cancer risk is gone."
Clearing the virus lowers the risk a great deal. If cirrhosis had already formed, some risk remains, which is why surveillance after treatment continues.
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On your report
The hepatitis C words you will meet, in plain language
- Anti-HCV
- The antibody test. Positive means you have met the virus at some point. It stays positive even after the virus is gone.
- HCV RNA
- The test for the virus itself. Detected means active infection that needs treatment. Not detected means the virus is not in the blood.
- Fibrosis
- Scarring in the liver. Early fibrosis can improve once the virus is treated.
- Cirrhosis
- Heavy, widespread scarring that changes the shape and working of the liver. This is the stage that carries the highest liver cancer risk.
- Universal precautions
- The hospital rule that every needle is used once and every instrument is sterilised, treating all blood as possibly infectious.
Did you know
India runs a National Viral Hepatitis Control Programme that offers testing and antiviral treatment through government facilities. The details of where and how change over time, so check with your nearest district hospital.
Being straight with you
What this page cannot tell you
It cannot tell you whether you have hepatitis C, or how you got it. Most people never find out the exact route, and that is fine. Treatment works the same way whatever the source. Only a blood test answers the first question.
It cannot judge a clinic or a dialysis unit
Safety practices have improved greatly, and most clinics today use a new syringe every time. If you are worried about a place where you are being treated now, ask them directly how they sterilise equipment and how often they test patients.
Who this does not apply to
If you have never had injections from unsafe sources, never received blood, never had dialysis and never shared drug equipment, your risk is low. A one-time test is still reasonable for any adult, but there is no need for alarm. If you already have liver cancer, read about hepatitis C treatment alongside cancer care, and see how hepatitis C spreads for the everyday questions.
If you have a positive result and do not know what to do next, call the helpline. Someone will explain the next test.Questions we are asked
Common questions about how hepatitis C spread in India
I had many injections as a child. Should I get tested?
Yes, it is worth one antibody test. Frequent injections in the past, especially from small clinics or local practitioners, are one of the commonest routes in India. The test is a simple blood sample and a negative result settles the question for good, unless you have a new exposure later.
I received blood after childbirth long ago. Is that a risk?
It can be, if the transfusion happened before donated blood was routinely screened for hepatitis C. Many women in that situation have never been tested. Ask for an anti-HCV test. Most will be negative, and anyone positive can be checked and treated.
Is blood transfusion safe in India now?
Licensed blood banks in India now screen donated blood for hepatitis C, hepatitis B and HIV. The risk has fallen sharply. No screening is perfect, so if you have regular transfusions, your doctor will usually check your hepatitis status from time to time.
I am on dialysis. How would I know if I caught it?
Usually you would not feel anything, which is why dialysis units test patients regularly. Ask your unit for your most recent hepatitis C result and keep a copy. If a test turns positive, your nephrologist and a hepatologist will plan treatment together.
Can I pass hepatitis C to my family at home?
Not through food, cooking, plates, hugging or sharing a room. Avoid sharing razors, toothbrushes or nail clippers, because they can carry tiny amounts of blood. Cover cuts. These simple habits protect everyone while you are being treated.
Does hepatitis C always lead to liver cancer?
No. Most people with hepatitis C never develop liver cancer. The risk rises mainly once cirrhosis has formed, which usually takes many years. Treating the virus early, before heavy scarring, is the most effective way to protect the liver.
If I clear the virus, do I still need scans?
If your liver had cirrhosis or advanced fibrosis, yes. Regular ultrasound checks continue because the scarred liver can still develop cancer. If your liver was healthy when treated, your doctor may tell you no special checks are needed.
Where can I start if I think I was exposed?
Ask your family doctor or a government health centre for an anti-HCV test. If it is positive, you will need an RNA test and a liver assessment. Call the CION helpline if you are unsure where to go, and someone will point you to the right specialist.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- World Health Organization — Hepatitis C
- National Viral Hepatitis Control Program (MoHFW) — National Viral Hepatitis Control Program
- NHS — Hepatitis C
- NIDDK — Hepatitis C - NIDDK
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Got a positive hepatitis C test and not sure what comes next?
Tell us what your report says and we will explain the next test and who should see you. If there is liver scarring, we can help plan regular checks. One helpline serves every CION centre.