Hepatitis

What is hepatitis?

Hepatitis is an inflammation of the liver. It can damage and destroy liver cells.

What causes hepatitis?

Hepatitis in children can be caused by many things. Your child can get hepatitis by being exposed to a virus that causes it. These viruses can include:

• Hepatitis viruses. There are 5 main types of the hepatitis virus: A, B, C, D, and E.
• Cytomegalovirus. This virus is a part of the herpes virus family.
• Epstein-Barr virus. The virus causes mononucleosis.
• Herpes simplex virus. Herpes can affect the face, the skin above the waist, or the genitals.
• Varicella zoster virus (chickenpox). A complication of this virus is hepatitis. But this happens very rarely in children.
• Enteroviruses. This is a group of viruses often seen in children. They include coxsackie viruses and echoviruses.
• Rubella. This is a mild disease that causes a rash.
• Adenovirus. This is a group of viruses that causes colds, tonsillitis, and ear infections in children. They can also cause diarrhea.
• Parvovirus. This virus causes fifth disease. Symptoms include a slapped-cheek rash on the face.

Conditions can also cause hepatitis in children. These can include autoimmune liver disease. For this disease, your child’s immune system makes antibodies that attack the liver. This causes inflammation that leads to hepatitis.

Who is at risk for hepatitis?

Children who are exposed to a virus that causes hepatitis are more likely to get hepatitis.

Hepatitis A

This form of the virus is passed through fecal-oral contact. It’s spread to children in the following ways:

• Eating food made by an infected person who didn’t wash his or her hands well after using the bathroom
• Drinking water that is contaminated by infected feces. This is a problem in developing countries.
• Touching an infected person's feces or dirty diaper then putting his or her hands near the mouth. Outbreaks may happen in child-care centers.
• International travel to areas where hepatitis A is common
• Using illegal drugs
• Blood transfusions. This is very rare.

Hepatitis B

Hepatitis B is spread when blood from an infected person enters another person's body. It can be spread through needle sticks, sharp instruments, and sharing items. These include razors and toothbrushes.

Babies may catch the virus during pregnancy if their mother has the virus. Children can spread it to others through household contact or through scrapes or cuts.

The following children are at risk for hepatitis B:

• Children born to mothers with hepatitis B
• Children born to mothers who have come from a country where hepatitis B is widespread. These include Southeast Asia and China.
• Children who live in long-term care facilities or who are disabled
• Children who live in households where someone is infected with the virus
• Children who have a blood clotting problem and need blood products. This can include hemophilia.
• Children who need dialysis for kidney failure
• Teenagers who do high-risk activities. These include IV (intravenous) drug use and unprotected sex.

Hepatitis C

Hepatitis C passes through infected blood. It can also be passed through sexual contact. Moms can also pass it to their babies during pregnancy. The following children are at risk for hepatitis C:

• Children born to mothers who have the virus
• Children who have a blood clotting problem, such as hemophilia
• Children who need dialysis for kidney failure
• Teenagers who do high-risk activities. These include IV (intravenous) drug use and unprotected sex.

Hepatitis D

This type of hepatitis can only happen with hepatitis B. Hepatitis D can happen at the same time your child is infected with hepatitis B, or it can start later.

Hepatitis D cannot be spread from a mom to her baby during pregnancy. This condition is rare in children born in the U.S. This is because the hepatitis B vaccine is given to babies. Hepatitis D only happens in patients already infected with hepatitis B.

Hepatitis E

This form of hepatitis is like hepatitis A. It’s spread through fecal-oral contact. Hepatitis E is most common in developing countries. It’s rare in the U.S.

What are the symptoms of hepatitis?

Symptoms can happen a bit differently in each child. Some children don’t have any symptoms.

Symptoms of fast onset (acute) hepatitis may include:

• Flu-like symptoms
• Yellowing of the skin or the whites of the eyes (jaundice)
• Fever
• Nausea or vomiting
• Loss of appetite
• Not feeling well
• Stomach pain or discomfort
• Diarrhea
• Joint pain
• Sore muscles
• Itchy red hives on the skin
• Clay-colored stools
• Dark-colored urine

The symptoms of this condition may look like symptoms of other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is hepatitis diagnosed?

Your child’s healthcare provider will check his or her health history. He or she will also give your child an exam. Your child may also need other tests.

Blood testing

Your child’s healthcare provider may do blood tests for the following:

• Liver enzymes
• Liver function
• Antibody and polymerase chain reaction. This is to check for the type of hepatitis.
• Cellular blood counts
• Coagulation tests. These include international normalized ratio.

CT scan

A CT scan shows detailed images of any part of the body. This test will show your child’s bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

US

Ultrasound uses sound waves to examine parts of the body. It is particularly effective in examining the liver.

MRI

This test uses large magnets, radio waves, and a computer. Together, these show detailed images of organs and structures inside your child’s body. Read more about having an MRI test.

Liver biopsy

Your child’s healthcare provider may take out a sample of tissue from your child’s liver. Then he or she may look at it closely under a microscope.

How is hepatitis treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child’s treatment will depend on what’s causing his or her hepatitis. The goal of treatment is to stop damage to your child’s liver. It’s also to help ease symptoms. Your child’s treatment may include:

• Medicines to control itching, treat the virus, or control an autoimmune disease
• Supportive care. This includes eating a healthy diet and getting enough rest.
• Avoiding alcohol and illegal drugs
• Blood testing. This can tell if the disease is progressing.
• Hospital stay. This is done in severe cases.
• Liver transplant. This is done for end-stage liver failure.
• Taking action to prevent the spread of viral hepatitis

What are the complications of hepatitis?

The main complications of hepatitis include liver failure, liver cancer, or death. This is more likely with hepatitis B or C.

Living with hepatitis

Work with your child’s healthcare provider to create a care plan for your child. If your child has chronic hepatitis, he or she will need to get plenty of rest, eat a healthy diet, and take medicines as prescribed.

When should I call my child's healthcare provider?

Call your child’s healthcare provider if your child has symptoms of hepatitis, such as jaundice. You should also call if your child is exposed to viruses that can cause the disease.

Key points about hepatitis

• Hepatitis is an inflammation of the liver. It can damage and destroy liver cells.
• The most common symptoms of hepatitis include jaundice and flu-like symptoms.
• Some children will not have any symptoms.
• Getting vaccinated and having good hygiene can prevent hepatitis.