Hepatitis C | Symptoms & Causes
What are the symptoms of hepatitis C?
The majority of children with acute or chronic hepatitis C have no symptoms. As they age, the virus can cause ever-greater damage to the liver. In later stages, symptoms of hepatitis C may include:
- tiredness
- itchy skin
- dark urine
- muscle soreness
- nausea
- loss of appetite
- stomach pain
- jaundice
What causes hepatitis C?
Hepatitis C is caused by infection with the hepatitis C virus (HCV). The virus is passed from person to person through contact with blood infected with HCV. Mothers infected with HCV can pass the virus on to their children at birth. While this is the most common way for a child in the United States to become infected with HCV, it is unusual. A mother infected with HCV has about a 5 percent (1 in 20) chance of passing the virus to her child. About a quarter of infants infected with the virus clear it without treatment by the time they reach age 3.
Older children, especially teenagers, can contract HCV through injection drug use. The virus can spread through other forms of contact with potentially infected blood (e.g., needle stick in a health care setting). Tattoos and body piercings appear to be safe as long as they are done with sterile instruments.
Hepatitis C | Diagnosis & Treatments
How is hepatitis C diagnosed?
If a doctor suspects your child is infected with HCV, they may test the child’s blood to see if it contains antibody to the virus. If the test comes back positive, the doctor will run additional tests for the virus itself and to see which genetic type, or genotype, of the virus your child is carrying. The results of this test will help the doctor recommend the next course of action.
Children and adults with chronic hepatitis C typically undergo periodic tests to monitor their liver inflammation and function and look for signs of serious liver disease.
How is hepatitis C treated?
The course of treatment for hepatitis C depends on what type of HCV your child is carrying. Some types are more common in the United States, while others are found more often in other parts of the world.
Acute and chronic hepatitis C are treated very differently. In prescribing treatment for hepatitis C, doctors aim to eliminate the virus and prevent the progressive liver damage that could lead to cirrhosis or liver cancer.
Treatments for acute hepatitis C
If a child has acute hepatitis C, doctors will typically recommend rest, healthy eating, and drinking plenty of fluids. In some cases, a doctor may prescribe medication to treat acute hepatitis C but most often, it clears up on its own.
Treatments for chronic hepatitis C
If the infection has lasted more than six months, doctors may start treatment with two drugs: peginterferon and ribavirin. Doctors do not treat children with hepatitis C until they reach age 3 because of concerns of possible toxicity and the low chance that a child younger than 3 will have significant liver damage from HCV.
Some children with other medical conditions, such as those with thalassemia, other viral infections, or serious kidney disease, may need to be treated differently. You should tell your doctor if your child has any other medical conditions before starting treatment for hepatitis C.
Should a child with hepatitis C get the hepatitis vaccine?
All children and adults with hepatitis C should be vaccinated against the other two major hepatitis viruses, hepatitis A and hepatitis B, in order to prevent additional liver inflammation and injury. There is currently no vaccine for hepatitis C.
How can hepatitis C affect my child in the long term?
Children with hepatitis C can lead completely normal lives, attend school, and play sports without any special arrangements.
If left untreated or if treatment fails, chronic hepatitis C can last for decades. During that time, it can progressively damage the liver and lead to such complications as cirrhosis and liver cancer. When they become older, children with hepatitis C should avoid drinking alcohol, as it can make the disease progress more quickly.
If the liver begins to fail because of the hepatitis and its complications, your child may need a liver transplant. While hepatitis C is one of the most common reasons for an adult to receive a liver transplant, it is not a common reason among children.
How we care for hepatitis C
The Center for Childhood Liver Disease at Boston Children's Hospital is one of the leading centers in the world for the care of children with hepatitis C. The center’s director, Maureen Jonas, MD, is a national leader in the care, diagnosis, and treatment for children with viral hepatitis. Dr. Jonas, along with her team, wrote the clinical guidelines that shape the way pediatric GI specialists and pediatricians around the country treat hepatitis C.
In addition to the standard treatments, our team of certified pediatric hepatologists is also at the forefront of treatment research, treating adolescents with newly approved treatments for adults and conducting clinical trials to help make them available to children as young as 3 years of age.
Our areas of innovation for hepatitis
Liver biopsies provide a great deal of information about the extent of damage in a child’s liver, but the procedure is invasive and can be both painful and risky. Researchers at Boston Children’s use an ultrasound-based imaging technology called FibroScan that may be able to help doctors assess liver scarring without a liver biopsy.
