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Hepatitis B In Children

What is hepatitis B?

Hepatitis B is an inflammation of the liver caused by hepatitis B virus (HBV) infection. The infection is called acute when a person first becomes infected. The infection becomes chronic after 6 months. Chronic hepatitis B is less common in children than in adults.


How is HBV spread?

HBV can spread from a mother to her unborn child. An infected mother can also infect her baby during delivery. HBV also spreads through contact with infected blood or body fluids. HBV can enter your child's body through a cut or scratch in his skin or through his mucus membranes. HBV can live on objects and surfaces for 7 days or longer.

What increases my child's risk for hepatitis B?

  • A stick from an infected needle, including for illegal drugs and for procedures such as tattooing
  • An object with infected blood or body fluids on it touches your child's wound
  • Close contact with an infected person, or your adolescent has unprotected sex with an infected person
  • Travel to areas in the world where HBV is common
  • Living or working in a long-term care facility or correctional facility
  • Rarely, a blood, organ, or tissue transplant from an infected donor

What are the signs and symptoms of hepatitis B?

Your child may have no signs or symptoms and may not know he has been infected. Once he is infected with HBV, it can take from 1 to 6 months before symptoms develop. He may have any of the following:

  • Dark urine or pale bowel movements
  • Fatigue and weakness
  • Fever
  • Loss of appetite, nausea, and vomiting
  • Jaundice (yellow skin or eyes), itchy skin, or skin rash
  • Joint pain and body aches
  • Pain in the right upper side of your child's abdomen

How is hepatitis B diagnosed?

Your child's healthcare provider will ask about his signs and symptoms and any health problems he has. Tell him if your child has other infections, such as HIV or hepatitis C. Tell him if your adolescent drinks alcohol or uses any illegal drugs. He may also ask about your adolescent's sex partners. Your child may need any of the following tests:

  • Blood tests are used to see if your child is infected with HBV and to check his liver function.
  • An ultrasound may be done to check for signs of HBV and to look for other liver problems.
  • A liver biopsy is used to test a sample of your child's liver for swelling, scarring, and other damage. A liver biopsy may help healthcare providers learn if your child needs treatment for HBV.

How is hepatitis B treated?

Hepatitis B may last a short time and go away on its own without treatment. Your child's healthcare provider will monitor his signs and symptoms closely for signs of liver disease. If needed, treatment may help improve the function of your child's liver and decrease his symptoms. He may need any of the following:

  • Medicines may be given to help fight HBV and keep it from spreading in your child's body.
  • A plasma or platelet transfusion may be needed if your child's blood is not clotting as it should. Plasma and platelets are parts of your child's blood that helps his blood clot. He will get the transfusion through an IV.
  • A liver transplant is surgery to replace your child's diseased liver with a donor liver. Your child may need a liver transplant if he has severe liver disease or liver failure.

What can I do to help prevent the spread of HBV?

  • Have your child cover any open cuts or scratches. If blood from a wound gets on a surface, clean the surface with bleach right away. Put on gloves before you clean. Throw away any items with blood or body fluids on them, as directed by your child's healthcare provider.
  • Do not let your child share personal items. These items include toothbrushes, nail clipper, and razors. Tell him not to share needles.
  • Tell household members that your child has HBV. People who live with your child should be vaccinated against HBV. If they have not been vaccinated, they may need to start treatment to help prevent infection. Regular handwashing is important for your child and everyone who lives with him. Everyone should wash after the bathroom and before eating. Ask your healthcare provider if you should tell childcare providers or school officials that your child has hepatitis B.
  • Talk to your adolescent about safe sex. If your adolescent is sexually active, tell him to use a condom during sex. Sexually active girls should have their male partners wear a condom.
  • Protect your baby. If you are pregnant, ask your healthcare provider for more information on keeping your baby from getting HBV. He will need a vaccination or treatment if you plan to breastfeed.
  • Do not let your child donate blood. Donations are screened for HBV, but it is best not to donate at all.

Manage hepatitis B:

  • Have your child eat a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy products, beans, lean meats and fish, and whole-grain breads. Ask if your child needs to be on a special diet.
  • Have your child drink more liquids. Liquids help your child's liver function properly. Ask your healthcare provider how much liquid your child should drink each day and which liquids are best for him.
  • Talk to your adolescent about not drinking alcohol. Alcohol can increase liver damage. Talk to your healthcare provider if your adolescent drinks alcohol and needs help to stop.
  • Talk to your adolescent about not smoking. Nicotine can damage blood vessels and make it more difficult to manage hepatitis B. Smoking can also lead to more liver damage. Tell your adolescent not use e-cigarettes or smokeless tobacco in place of cigarettes or to help him quit. They still contain nicotine. Ask your healthcare provider for information if your adolescent currently smokes and needs help quitting.

What are the risks of hepatitis B?

  • Even with treatment, hepatitis B can damage your child's liver. If he needs cancer treatment or takes certain other medicines, hepatitis B may return or get worse. This includes medicines he takes after an organ or bone marrow transplant or to treat HIV or autoimmune disorders.
  • Without treatment, your child's risk for chronic HBV, cirrhosis, liver fibrosis (scarring), and liver failure increases. He may get an infection in his abdomen, and he may have bleeding in your stomach and esophagus. Liver disease may lead to increased pressure in your child's brain. His risk for liver cancer also increases.

When should I seek immediate care?

  • Your child has a sudden, severe headache and head pressure.
  • Your child has new or increased bruising or red or purple dots on his skin. He may also have bleeding that does not stop easily.
  • Your child's abdomen is swollen.
  • Your child has severe nausea or cannot stop vomiting.
  • You see blood in your child's urine or bowel movements, or he vomits blood.
  • Your child has new or increased yellowing of his skin or the whites of his eyes.
  • Your child has severe pain in his upper abdomen.

When should I contact my child's healthcare provider?

  • The palms of your child's hands are red.
  • Your child has a fever.
  • Your child has new or increased swelling in his legs, ankles, or feet.
  • Your child's muscles get smaller and weaker.
  • You have questions about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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