When Your Child Has the Hepatitis B Virus (HBV)

How did my child get hepatitis B?

HBV spreads through blood and bodily fluids. Infection can happen when blood containing the virus gets into a healthy person’s body. In many cases, how a person became infected is not known for sure. HBV can be passed in these 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 U.S.

• 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 often mild in children. They may include:

• Nausea and vomiting

• Diarrhea

• Loss of appetite

• Fatigue (tiredness)

• Aching muscles or joints

• Jaundice (yellowing of the skin and whites of the eyes, dark urine, or gray- or clay-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

• Headache

• Sore muscles and joints

• Upset stomach, vomiting, or diarrhea

• Jaundice

• Itchy skin

• Low-grade fever

How is hepatitis B diagnosed?

The healthcare provider asks questions to find out how your child may have been exposed to HBV. The healthcare provider also does an exam. Your 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 your child comfortable and treating symptoms. It's done the same way you would treat flu symptoms.

• Give your child plenty of fluids to help prevent dehydration. Good choices are water, a child’s electrolyte solution, or moderate amounts of juice.

• Make sure your child gets plenty of rest.

• Check with your 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.

Most healthy children age 5 and older get better without treatment.

How is chronic hepatitis B treated?

Medicine can 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 talk with you about the pros and cons of medicine.

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 not be taken. 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, they can't 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 stay away from alcohol at a young age, they 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 prevent 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 watch the health of your child’s liver. Chronic hepatitis B can lead to cirrhosis (irreversible damage) of the liver and liver cancer. Your child’s healthcare provider can talk with you about your child’s condition, follow-up visits, 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 gray- or clay-colored stools (jaundice)

• Has unintended weight loss

• Continues to vomit

• Loses consciousness

• 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