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Hepatitis C - children

Definition

Hepatitis C in children is swelling and inflamed tissue of the liver. It occurs due to infection with hepatitis C virus (HCV).

Other common hepatitis virus infections include hepatitis A and hepatitis B.

Alternative Names

Silent infection - HCV children; Antivirals - hepatitis C children; HCV children; Pregnancy - hepatitis C - children; Maternal transmission - hepatitis C - children

Causes

A child may get HCV from an HCV-infected mother, at the time of birth.

Almost 6 out of every 100 infants born to mothers with an HCV infection have hepatitis C. There is no treatment to prevent hepatitis C at birth.

Adolescents and teens can also get an HCV infection. There are many causes of hepatitis C in teens, including:

  • Being stuck with a needle after use by an HCV-infected person
  • Coming in contact with the blood of an infected person
  • Using street drugs
  • Having unprotected sexual contact with a person with HCV
  • Getting tattoos or acupuncture therapy with infected needles

Hepatitis C does not spread from breastfeeding, hugging, kissing, coughing, or sneezing.

Symptoms

Symptoms develop in children about 4 to 12 weeks after infection. If the body is able to fight HCV, the symptoms end within a few weeks to 6 months. This condition is called acute hepatitis C infection.

However, some children never get rid of HCV. This condition is called chronic hepatitis C infection.

Most children with hepatitis C (acute or chronic) do not show any symptoms until more advanced liver damage is present. If symptoms do occur, they may include:

  • Pain in the right upper abdomen
  • Clay-colored or pale stools
  • Dark urine
  • Tiredness
  • Fever
  • Yellow skin and eyes (jaundice)
  • Loss of appetite
  • Nausea and vomiting

Exams and Tests

Your child's health care provider will perform blood tests to detect HCV in blood. Two most common blood tests are:

  • Enzyme immunoassay (EIA) to find the hepatitis C antibody
  • Hepatitis C RNA assays to measure virus levels (viral load)

Infants born to hepatitis C-positive mothers should undergo testing at 18 months of age. This is the time when antibodies from the mother will decrease. At that time, the test will more truly reflect the baby's antibody status.

The following tests detect liver damage from hepatitis C:

These tests show how well your child's treatment is working.

Treatment

The main aim of treatment in children is to relieve the symptoms and stop the disease from spreading. If your child has symptoms, make sure that your child:

  • Gets plenty of rest
  • Drinks lots of fluids
  • Eats healthy food

Acute hepatitis C does not need any special treatment. However, your child can pass the virus to others. You should take steps to help prevent the disease from spreading.

Chronic hepatitis C needs treatment. The goal of treatment is to prevent complications.

If there is no sign of the HCV infection after 6 months, then your child has fully recovered. However, if your child develops chronic hepatitis C, it can cause liver disease later in life.

Your child's provider may recommend antiviral medicines for chronic HCV. These medicines:

  • Have fewer side effects
  • Are easier to take
  • Are taken by mouth

The choice of whether to use medicines in children for hepatitis C is not clear. Medicines that have been used, interferon and ribavirin, carry a lot of side effects and some risks. Newer and safer medicines have been approved for adults, but not yet for children. Many experts recommend waiting on treatment of HCV in children until these newer medicines are approved for use in children.

Outlook (Prognosis)

Children younger than 3 years old may not need any treatment. Infection in this age group often resolves without any complications.

Possible Complications

The possible complications of hepatitis C are:

These complications generally occur during adulthood.

When to Contact a Medical Professional

Call your provider if your child has symptoms of hepatitis C. You should also contact your provider if you have hepatitis C and become pregnant.

Prevention

There are no vaccinations for hepatitis C. Therefore, prevention plays an important role in managing the disease.

In a household where someone with hepatitis C is living, take these steps to help prevent the spread of the disease:

  • Avoid contact with blood. Clean any blood spills using bleach and water.
  • Mothers with HCV should not breastfeed if nipples are cracked and bleeding.
  • Cover cuts and sores to avoid contact with body fluids.
  • Do not share toothbrushes, razors, or any other items that may be infected.

References

Jensen MK, Balistreri WF. Viral hepatitis. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 358.

Jhaveri R, El-Kamary SS. Hepatitis C virus. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 177.

Ward JW, Holtzman D. Epidemiology, natural history, and diagnosis of hepatitis C. In: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, eds. Zakim and Boyer's Hepatology. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 29.


Review Date: 2/19/2018
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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