What is Hepatitis C and How is it Transmitted?
Hepatitis C (HCV) is a viral infection that causes inflammation of the liver. It was first recognized in the 1970s, but there was no test for it until 1989. HCV is one of the viruses (A, B, C, D, & E) which together form the vast majority of cases of viral hepatitis. It's classified into eleven major genotypes, many subtypes, and about a hundred different strains based on the genomic sequence.
The means of HCV transmission are primarily through contact with human blood, and as anyone who has a tattoo or body piercing knows, these practices involve a definite risk of transmission if not properly done in a sterile and careful environment.
A Viral Time Bomb
It's of vital importance that proper sterile procedure be followed when receiving or performing any type of tattoo or other body alteration. The artist doing the procedure and the client both have a responsibility to themselves, each other, and all of the people that they come into regular contact with.
Hepatitis C has been compared to a viral time bomb. The World Health Organization (WHO) estimates that about 180 million people are infected with HCV and that 130 million of those are chronic HCV carriers at risk of developing liver cirrhosis and/or liver cancer. It's also estimated that there are three to four million people newly infected with HCV each year. Hepatitis C has no known cure nor any known vaccine. Few people recover from HCV--most (80-85%) cases become chronic; monitoring the disease can be difficult, and suppressive medication is very costly and many times ineffective. HCV is responsible for 50%-76% of all liver cancer cases and two thirds of all liver transplants in the developed world.
The incubation period for HCV ranges from 2 - 26 weeks with many infected people living life symptom free. Often, symptoms don't show until ten or even twenty years later. A majority of infected people have no idea that they're carrying HCV, largely because HCV is typically asymptomatic and the tests used to find it are not sensitive enough to truly measure zero virus in the blood.
Hep C and Body Art
Here is where hepatitis C and the body art industry meet. Prevention through sterile procedure and thoughtful actions on the part of the artist and customer are of primary importance. There is conflicting information out there about how long the hepatitis C virus can survive outside of the human body. Some sources cite two weeks and some say as long as a month. What is known is that the virus outside of the body forms a celluloid shell around the rna strand that enables HCV to live outside a host for an extended amount of time compared to most any other blood borne infectious disease. Other diseases like HIV and AIDS are very delicate and only survive outside a body for a few seconds and the CDC reports of no known cases of transmission through tattooing or piercing. HCV, on the other hand, has the potential to be an epidemic within this industry. Careful practice and overkill (as if there is such a thing) on sterile technique seem to be the only means of securing the health and well-being of all involved.
So, when you go to a studio to receive new body art, be informed and educated about what to ask and the right answers to those questions. Do they know how HCV spreads? Are they as educated and informed about the risks of HCV as they should be? Do they follow sterile rocedure? Do they use a viricide that is capable of killing HCV? Do they even know what kills it? Unfortunately, from my personal experience, that is rarely the case.
There are only a limited number of products that kill the hepatitis C virus--make sure one is being used. Unfortunately, tattoo artists often only have access to a very limited number of the products that do kill HCV. Most are for sale only to licensed health facilities. (Tattoo and piercing shops are not considered within this category.) Incidentally, just because a hospital or ambulance service uses a product, that doesn’t guarantee it will kill HCV. Read the labels. I had a discussion with a local EMT about this very subject and she argued with me about it. The next time she came in, she told me her and her partner pulled every cleaner they had on the shelves and checked them to see if they were effective against HCV--none of them were. Governmental agencies don’t always keep you safe, but a well-informed, educated and caring tattoo artist will.
Tip: One simple option is chlorine bleach. According to the EPA, a solution of at least 2.4% is sufficient. (Remember that when mixed with water, bleach is only effective for a limited amount of time.) Bleach is hard on the surfaces in the stations and leaves a residue that needs cleaning constantly, but it’s also affordable, easy to find, and it works.
I have personally asked Health Department inspectors about what actually kills HCV and they are no more informed than any person off the street. Another thing is that here in India, anyone can open a tattoo shop as long they pay the required fees to open the shop. There is no requirement that anyone working within this field have any blood borne pathogen training for cross contamination procedures. There is not even the guarantee that they learned how to tattoo through any legitimate means. Your tattoo artist could have been your cable installer last week.
I’m not trying to point fingers at anyone or say that a self-taught artist can’t follow proper cross-contamination procedures; any person within this industry has an obligation to become well educated about all aspects, good and bad, of their job. Your health and life are in your hands. Do some research, ask questions, and if your artist doesn’t know the answers, go somewhere else.
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