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Hepatitis B in Children


What is hepatitis B?

Hepatitis B is 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?

  • The following increase the risk for your adolescent:
    • A stick from an infected needle, including for illegal drugs and for procedures such as tattooing
    • Unprotected sex with an infected person, sex with more than one partner, or being a male who has sex with males
  • The following increase the risk for your child or adolescent:
    • An object with infected blood or body fluids on it touches a wound
    • Close contact 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. These can harm his liver. The healthcare provider 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 him closely for signs of liver disease. If needed, treatment may help improve your child's liver function 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 help 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 clippers, and razors. Tell him not to share needles.
  • Tell household members that your child has HBV. Anyone who has not been vaccinated against hepatitis B may need to start treatment to help prevent infection. Everyone should wash their hands often, especially after using the bathroom and before eating. Regular handwashing is important for your child and everyone who lives with him.
  • 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. Ask your healthcare provider for information if your adolescent currently smokes and needs help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before your adolescent uses these products.

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 or concerns 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 healthcare providers 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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.