When Your Child Has Hepatitis B (HBV) Infection
Hepatitis is an inflammation of the liver. Many things can cause it. One of the causes is infection with a virus called the hepatitis B virus (HBV). The illness caused by hepatitis B infection can be acute (short-term) or chronic (long-term). Acute hepatitis B causes flulike symptoms. It’s usually mild in children. In most cases, the virus dies off after this acute infection. But if HBV stays in the child’s body after the acute illness, this means the child has chronic hepatitis. This almost never causes symptoms. But, the virus can damage the liver over time. Also, a child with chronic hepatitis B can spread HBV to others.
How did my child get hepatitis B?
HBV spreads through blood. Infection can happen when blood containing the virus enters a healthy person’s body. In many cases, how a person became infected is not known for sure. HBV can be passed in the following ways:
From mother to baby during childbirth.
Through contact with infected blood, such as by touching an open cut or scrape. HBV can also spread if you use an item that has even a tiny amount of an infected person’s blood on it. This includes personal items (such as toothbrushes, nail clippers, razors, or pierced earrings), and tattoo or drug needles.
Through infected blood products during a transfusion. Careful screening of donated blood makes this type of transmission very rare in the United States.
During dialysis (a treatment for kidney failure).
Through unprotected sex with an infected person.
What are the symptoms of hepatitis B?
Acute hepatitis B symptoms are usually mild in children. They may include:
Nausea and vomiting
Loss of appetite
Aching muscles or joints
Jaundice (yellowing of the skin and whites of the eyes, dark urine, or light-colored stools)
Chronic hepatitis B often does not cause symptoms. When symptoms do occur, they can include:
Pain in the upper right abdomen (where the liver is)
Tiredness and weakness
Sore muscles and joints
Upset stomach, vomiting, or diarrhea
How is hepatitis B diagnosed?
The healthcare provider asks questions to determine when the child may have been exposed to HBV. The healthcare provider also does an exam. The child’s blood is tested for HBV. Other tests may be done to see how healthy the liver is and to look for signs of liver damage.
How is acute hepatitis B treated?
Treatment of acute HBV infection focuses on making the child comfortable and treating symptoms (the same way you would treat flu symptoms). This includes:
Giving the child plenty of fluids to help prevent dehydration. Good choices are water, a child’s electrolyte solution, or moderate amounts of juice.
Making sure the child gets plenty of rest.
Checking with the child’s healthcare provider before using any over-the-counter medicines. The liver processes all medicine. A child with hepatitis B may not be able to take certain medicines.
How is chronic hepatitis B treated?
Medicine is available to treat chronic HBV infection. In some cases, medicine can reduce the amount of HBV in the child’s body to levels that can’t be detected. This lowers the chance of liver damage. But medicines have risks. Your child’s healthcare provider can discuss the pros and cons of medicine with you.
Protect your child’s health and prevent spread
Ask your child’s healthcare provider for a list of medicines the child should not take. Many prescription and over-the-counter medicines stress the liver. These should be avoided. Tell any healthcare provider who prescribes medicine for your child that your child has hepatitis.
Be aware that some herbs and supplements can strain the liver. Talk with your child’s healthcare provider before giving the child anything you buy over the counter.
Make sure your child eats healthy foods. A diet low in fat, high in fiber, and full of fresh fruits and vegetables can help keep your child healthy.
Once a child has hepatitis B, he or she cannot get it again. But do have your child vaccinated against hepatitis A. This is another form of hepatitis that could cause serious damage to the liver.
Teach your child to not drink alcohol. Alcohol can cause severe liver damage in people with hepatitis. If you teach your child to avoid alcohol at a young age, he or she may be more likely to drink less or abstain as an adult.
Be sure to have other people in the household vaccinated against both hepatitis A and B.
Teach your child how to prevent the spread of hepatitis B to others. Take precautions to avoid exposing yourself to your child’s hepatitis B.
What are the long-term concerns?
A child with chronic HBV infection should visit the healthcare provider regularly. Checking the liver often can help prevent problems. This way, your child's healthcare provider can watch for liver damage. Tests will be done to monitor the health of your child’s liver. Your child’s healthcare provider can talk with you about your child’s condition, how often to visit, and ways to help keep your child’s liver healthy.
When to call your child's healthcare provider
Call your child's healthcare provider if your child:
Has signs of dehydration. These include decreased urination, very dark urine, dry mouth, refusal to drink fluids, and no tears when crying.
Is extremely irritable or drowsy
Has yellowing of the skin or eyes, dark urine, or light colored stools (jaundice)
Has unintended weight loss
Continues to vomit
Has swelling in the hands, arms, feet, ankles, abdomen, or face
Bleeds from the nose, mouth, or rectum, or has bloody stools
Bruises more easily than normal
September 29, 2017
Diagnosis of hepatitis B virus infection. UpToDate., Epidemiology, transmission, and prevention of hepatitis B virus infection. UpToDate., Hepatitis B virus vaccination. UpToDate., Overview of hepatitis B virus infection in children and adolescents. UpToDate.
Adler, Liora C., MD,Freeborn, Donna, PhD, CNM, FNP